右江医学2024,Vol.52Issue(5) :393-398.DOI:10.3969/j.issn.1003-1383.2024.05.002

老年人胫腓骨骨折特征及就医经济负担研究

Study on characteristics and economic burden of tibia-fibula fracture in the elderly

黄承夸 赵彤 廖正文 陆文德 黄远剑 杨伟康 农圣
右江医学2024,Vol.52Issue(5) :393-398.DOI:10.3969/j.issn.1003-1383.2024.05.002

老年人胫腓骨骨折特征及就医经济负担研究

Study on characteristics and economic burden of tibia-fibula fracture in the elderly

黄承夸 1赵彤 1廖正文 1陆文德 1黄远剑 1杨伟康 1农圣2
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作者信息

  • 1. 右江民族医学院附属西南医院暨百色市人民医院骨科,广西百色 533000
  • 2. 右江民族医学院公共卫生与管理学院,广西百色 533000
  • 折叠

摘要

目的 了解百色市 60 岁以上老年人胫腓骨骨折患者的流行病学特征及疾病经济负担.方法 使用回顾性研究方法,抽取百色市人民医院 2021 年老年人胫腓骨骨折住院患者,通过病因分析了解老年人胫腓骨骨折的流行病学特征并测算其住院医疗成本和结构,为预防老年人胫腓骨骨折、减轻患者疾病经济负担提供科学依据.结果 共收集有效病例 98 例,其中男性 57 例(占 58.2%),女性 41 例(占 41.8%),性别比为 1.39∶1.患者的平均年龄为69 岁,最大年龄为 88 岁.伤害事故特征为:道路交通事故(占 46.94%)、跌倒(占 31.63%)和坠落(占 16.33%)是前三位致伤原因,约占总病例数的 95%,一年之中春冬两季伤害发生率最高(62.24%).骨折临床特征:开放性骨折和闭合性骨折分别占 11.22%和 88.78%,胫腓骨远端骨折(30.61%)、胫骨骨干骨折(26.53%)、胫骨平台骨折(22.45%)是前三位主要损伤类型.胫腓骨骨折总医疗成本为 292.7 万元,人均住院费用为 29 871 元,其中医保参与支付仅54 例占55.10%,实际报销比例平均为55.6%,报销比例最高为92.49%.因老年人胫腓骨骨折陪护造成的损失约为 23.5 万元,人均照护成本 2398 元.结论 道路交通事故、跌倒和坠落是老年人胫腓骨骨折入院的前三位致伤原因,应提高老年人驾驶两轮车辆及日常劳作的自我安全意识,加强健康预警和教育;医药费用自付比例高且医保实际报销不高,家人照护负担较重,应增强老年人社会医疗保险的缴费意愿,呼吁社会多方渠道减轻老年人的医疗经济负担.

Abstract

Objective To understand the epidemiologic characteristics and the economic burden of disease in patients with tibia-fibula fracture in the elderly over 60 years old in Baise City.Methods A retrospective research method was used,elderly patients with tibia-fibula fracture admitted to Baise People's Hospital in 2021 were selected to understand the epidemi-ological characteristics of tibia-fibula fracture in the elderly through etiological analysis and to measure the cost and structure of hospitalized medical care,so as to provide scientific basis for the prevention of tibia-fibula fracture in the elderly and the reduction of patients'economic burden of the disease.Results A total of 98 valid cases were collected,of which 57 cases(58.2%)were male and41cases(41.8%)werefemale,withasexratioof1.39∶1.Theaverageageofthepatientswas 69 years old,and the maximum age was 88 years old.The characteristics of injury accidents were:road traffic accidents(46.94%),falls(31.63%)and drops(16.33%)werethetopthreecausesofinjury,accountingforabout95% oftheto-tal number of cases,with the highest incidence of injuries occurring in spring and winter of the year(62.24%).Clinical characteristics of fractures:open and closed tibia-fibula fractures in the elderly accounted for about 11.22% and 88.78% of the total cases,respectively,with distal tibia-fibula fracture(30.61%),tibial tuberosity fracture(26.53%),and tibial plateau fracture(22.45%)being the top three types of major injuries.The total medical cost of tibia-fibula fracture was 2 927 000 yuan,and per capita hospitalization cost was 29 871 yuan,of which the number of cases of health insurance par-ticipation in payment accounted for 55.10%,and average actual reimbursement ratio was 55.6%,with the highest reim-bursement ratio being 92.49%.The loss caused by tibia-fibula fracture in the elderly was about 235 000 yuan,and the per capita care cost was 2398 yuan.Conclusion Road traffic accidents,falls and drops are the top three causes of tibia-fibula fracture in the elderly admitted to the hospital,suggesting that the self-safety awareness of elderly people driving two-wheeled vehicles and daily labor should be improved,and health warnings and education should be strengthened;the high out-of-pocket ratio of medical costs and the actual reimbursement by health insurance is not high,and the burden of family care is heavy,so it is necessary to enhance the willingness of the elderly to pay for social medical insurance,and call on society to reduce the medical economic burden of the elderly through multiple channels.

关键词

老年人/胫腓骨骨折/经济负担

Key words

the elderly/tibia-fibula fracture/economic burden

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基金项目

国家自然科学基金(72164036)

广西自然科学基金(2020GXNSFAA238028)

右江民族医学院校级科研项目(yy2020ky068)

出版年

2024
右江医学
右江民族医学院附属医院

右江医学

影响因子:0.779
ISSN:1003-1383
参考文献量9
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