Impact of hip fracture on hospital care costs: a population-based study.
Impact of hip fracture on hospital care costs: a population-based study.
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DOI：
10.1007/s00198-015-3277-9
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发表时间：
2016-02
期刊：
影响因子：
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通讯作者：
REFReSH study group
中科院分区：
文献类型：
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作者：
Leal J;Gray AM;Prieto-Alhambra D;Arden NK;Cooper C;Javaid MK;Judge A;REFReSH study group
使用一个大型髋部骨折患者队列，我们估计骨折后第一年和第二年的住院费用分别为14，163英镑和2139英镑。第二，髋部和非髋部骨折是主要的成本驱动因素。有一个强大的经济动机，以确定成本效益的方法，预防髋部骨折。本研究的目的是评估髋部骨折术后2年的住院费用，并比较骨折前后的费用。从医院记录中确定了2003年至2013年期间在英国某地区因髋部骨折入院的60岁以上患者队列，并对其进行了随访，直至死亡或行政审查。使用2012/2013年单位成本对所有医院记录进行估值，并在估计平均年成本时使用非参数删失方法对删失进行调整。一个广义线性模型研究了医院成本的主要预测因素。确定了33，152例髋部骨折患者的队列（平均年龄83岁（SD 8.2））。指数髋部骨折后，经删失调整的1年和2年平均住院费用分别为14，163英镑（95%置信区间（CI）14，008英镑至14，317英镑）和16，302英镑（95% CI 16，097英镑至16，515英镑）。指数入院占1年总住院费用的61%（8613英镑; 95% CI 8565英镑至8661英镑），与事件前一年相比高出10，964英镑（p < 0.001）。1年住院费用的主要预测因素是第二次髋部骨折、其他需要住院的非髋部脆性骨折和髋部骨折相关并发症。英国每年与髋部骨折相关的医院总费用估计为11亿英镑。髋部骨折后的住院费用很高，并且大多发生在髋部骨折后的第一年。在指数骨折后经历第二次髋部骨折占成本增加的大部分。有强烈的经济动机优先考虑研究资金，以确定预防指数和随后的髋部骨折的最佳方法。
Using a large cohort of hip fracture patients, we estimated hospital costs to be £14,163 and £2139 in the first and second year following fracture, respectively. Second hip and non-hip fractures were major cost drivers. There is a strong economic incentive to identify cost-effective approaches for hip fracture prevention. The purpose of this study was to estimate hospital costs of hip fracture up to 2 years post-fracture and compare costs before and after the index fracture. A cohort of patients aged over 60 years admitted with a hip fracture in a UK region between 2003 and 2013 were identified from hospital records and followed until death or administrative censoring. All hospital records were valued using 2012/2013 unit costs, and non-parametric censoring methods were used to adjust for censoring when estimating average annual costs. A generalised linear model examined the main predictors of hospital costs. A cohort of 33,152 patients with a hip fracture was identified (mean age 83 years (SD 8.2). The mean censor-adjusted 1- and 2-year hospital costs after index hip fracture were £14,163 (95 % confidence interval (CI) £14,008 to £14,317) and £16,302 (95 % CI £16,097 to £16,515), respectively. Index admission accounted for 61 % (£8613; 95 % CI £8565 to £8661) of total 1-year hospital costs which were £10,964 higher compared to the year pre-event (p < 0.001). The main predictors of 1-year hospital costs were second hip fracture, other non-hip fragility fractures requiring hospitalisation and hip fracture-related complications. Total UK annual hospital costs associated with incident hip fractures were estimated at £1.1 billion. Hospital costs following hip fracture are high and mostly occur in the first year after the index hip fracture. Experiencing a second hip fracture after the index fracture accounted for much of the increase in costs. There is a strong economic incentive to prioritise research funds towards identifying the best approaches to prevent both index and subsequent hip fractures.