Jacobs M J, Markel D C
Department of Surgery, Providence Hospital, Southfield, Michigan, USA.
Am J Orthop (Belle Mead NJ). 1999 Oct;28(10):573-6.
Hip fractures have a high economic and social cost to society. Rising healthcare costs, coupled with managed healthcare systems, have forced a close inspection of healthcare expenditures. To evaluate the impact of geriatric intertrochanteric hip fractures upon a hospital system, an economic cost-analysis was undertaken. An analysis was made of financial and hospital data of elderly patients who sustained an intertrochanteric hip fracture and subsequently underwent open reduction and internal fixation. Increasing patient age did not correlate with length of stay, overall hospital cost, or net hospital income. When costs were subdivided, there were no statistically significant differences relative to patient age for costs of pharmacy, radiology, respiratory therapy, or operating room supply. There were, however, statistically significant correlations between patient age and costs of the operating room, blood, and anesthesia. During the 36-month study period, a case manager was added to the orthopedic surgical team. There was a trend toward decreased length of stay after the addition of the case manager, but the overall cost of patient care was not affected.
髋部骨折给社会带来了高昂的经济和社会成本。不断上涨的医疗费用,再加上管理式医疗系统,促使人们对医疗支出进行严格审查。为了评估老年股骨转子间髋部骨折对医院系统的影响,我们进行了一项经济成本分析。我们对发生股骨转子间髋部骨折并随后接受切开复位内固定术的老年患者的财务和医院数据进行了分析。患者年龄的增加与住院时间、医院总成本或医院净收入并无关联。当对成本进行细分时,在药房、放射科、呼吸治疗或手术室耗材成本方面,相对于患者年龄不存在统计学上的显著差异。然而,患者年龄与手术室、血液及麻醉成本之间存在统计学上的显著相关性。在为期36个月的研究期间,骨科手术团队增加了一名病例管理员。增加病例管理员后住院时间有缩短的趋势,但患者护理的总成本并未受到影响。