Total medical costs of treating femoral neck fracture patients with hemi- or total hip arthroplasty: a cost analysis of a multicenter prospective study.
Total medical costs of treating femoral neck fracture patients with hemi- or total hip arthroplasty: a cost analysis of a multicenter prospective study.
复制标题
DOI：
10.1007/s00198-016-3484-z
复制
发表时间：
2016-06
期刊：
影响因子：
--
通讯作者：
HEALTH Trial Investigators
中科院分区：
文献类型：
--
作者：
Burgers PT;Hoogendoorn M;Van Woensel EA;Poolman RW;Bhandari M;Patka P;Van Lieshout EM;HEALTH Trial Investigators
本研究的目的是确定健康老年患者采用半髋关节或全髋关节置换术治疗移位的股骨颈骨折的总医疗费用。在两年的随访中，每个患者的平均总成本为26,399欧元。这些结果有助于提高成本意识。髋部骨折的绝对数量正在上升，并增加了本已沉重的社会负担。本研究的目的是确定健康老年患者采用半髋关节或全髋关节置换术治疗移位的股骨颈骨折的平均总医疗费用。该人群是一项国际随机对照试验的荷兰样本，该试验包括接受半髋关节或全髋关节置换治疗的股骨颈骨折患者。在总共2年的随访期内，前瞻性地收集了患者数据和卫生保健利用情况。费用分为初级住院期间的医院护理费用、临床随访的医院费用和康复期间在医院外产生的费用。多重推算被用来解释缺失的数据。141名参与者(平均年龄81岁)的数据被纳入分析。2年死亡率为19%。经过10周的随访，每个患者的平均总成本为15,216欧元。经过1年和2年的随访，平均总成本分别为23,869欧元和26,399欧元。康复是主要的成本决定因素，占总成本的46%。初级住院天数占总费用的22%，指数手术占11%，理疗占7%。在治疗移位的股骨颈骨折后，半髋关节或全髋关节置换术的主要成本决定因素(两年前每个患者26,399欧元)是康复和疗养院。大部分成本是在第一年产生的。减少髋部骨折手术后的成本应侧重于提高康复阶段的持续时间和效率。本文的在线版本(doi：10.1007/s00198-0163484-z)包含补充材料，授权用户可以使用。
The aim of this study was to determine the total medical costs for treating displaced femoral neck fractures with hemi- or total hip arthroplasty in fit elderly patients. The mean total costs per patient at 2 years of follow-up were €26,399. These results contribute to cost awareness. The absolute number of hip fractures is rising and increases the already significant burden on society. The aim of this study was to determine the mean total medical costs per patient for treating displaced femoral neck fractures with hemi- or total hip arthroplasty in fit elderly patients. The population was the Dutch sample of an international randomized controlled trial consisting of femoral neck fracture patients treated with hemi- or total hip arthroplasty. Patient data and health care utilization were prospectively collected during a total follow-up period of 2 years. Costs were separated into costs for hospital care during primary stay, hospital costs for clinical follow-up, and costs generated outside the hospital during rehabilitation. Multiple imputations were used to account for missing data. Data of 141 participants (mean age 81 years) were included in the analysis. The 2-year mortality rate was 19 %. The mean total cost per patient after 10 weeks of follow-up was €15,216. After 1 and 2 years of follow-up the mean total costs were €23,869 and €26,399, respectively. Rehabilitation was the main cost determinant, and accounted for 46 % of total costs. Primary hospital admission days accounted for 22 % of the total costs, index surgery for 11 %, and physical therapy for 7 %. The main cost determinants for hemi- or total hip arthroplasty after treatment of displaced femoral neck fractures (€26,399 per patient until 2 years) were rehabilitation and nursing homes. Most of the costs were made in the first year. Reducing costs after hip fracture surgery should focus on improving the duration and efficiency of the rehabilitation phase. The online version of this article (doi:10.1007/s00198-016-3484-z) contains supplementary material, which is available to authorized users.