Borgquist L, Lindelöw G, Thorngren K G
Department of Community Health Sciences, Dalby.
Acta Orthop Scand. 1991 Feb;62(1):39-48. doi: 10.3109/17453679108993089.
Costs related to functional status were calculated for 180 consecutive hip fracture patients (mean age 78 years) who were admitted from their own home and rehabilitated in primary health care. Within 4 months after the fracture, 75 percent of the patients had been discharged to their own home, 9 percent were dead, and the short-term medical treatment costs per patient were SEK 43,000, whereas the total costs including communal help and costs for living accommodations after discharge were twice as high. The total costs per patient for long-term medical treatment (from 4 months up to 3 years after fracture) were 7 percent of the short-term medical treatment costs. Patients with a cervical fracture discharged to their own home and with good functional status consumed only one fifth of the resources that patients with a trochanteric fracture discharged to institutional care and who had reduced functional status consumed. A substantial part of the costs can be saved by improved organization of rehabilitation after discharge from the hospital. A further cost reduction would require a combination of technologic, social, and organizational changes aimed at early discharge and continued follow-up in primary health care.
对180例连续入住的髋部骨折患者（平均年龄78岁）进行了与功能状态相关的费用计算，这些患者均从家中入院，并在初级卫生保健机构接受康复治疗。骨折后4个月内，75%的患者已出院回家，9%的患者死亡，每位患者的短期医疗费用为43,000瑞典克朗，而包括社区帮助和出院后生活住宿费用在内的总费用则是其两倍。每位患者的长期医疗费用（骨折后4个月至3年）为短期医疗费用的7%。出院回家且功能状态良好的颈椎骨折患者消耗的资源仅为出院后入住机构护理且功能状态下降的转子间骨折患者的五分之一。通过改善出院后康复的组织安排，可以节省大量费用。进一步降低费用需要技术、社会和组织变革相结合，以实现早期出院并在初级卫生保健机构持续随访。
