Yang Yicheng, Du Fen, Ye Wenyu, Chen Yu, Li Jinghu, Zhang Jie, Nicely Helen, Burge Russel
Patient Outcomes and Real World Evidence, Lilly Suzhou Pharmaceutical Co, Ltd, Shanghai, People's Republic of China.
Pharmacoeconomics and Outcomes Research, Beijing Brainpower Pharma Consulting Co, Ltd, Beijing, People's Republic of China.
Clinicoecon Outcomes Res. 2015 Apr 13;7:205-12. doi: 10.2147/CEOR.S77175. eCollection 2015.
The objective of this study was to provide new estimates on the per-admission inpatient hospital cost and per-admission length of stay (LOS) for osteoporosis-related fractures in mainland China.
Data for inpatient hospitalization associated with at least one osteoporosis-related fracture were obtained from the nationwide China Health Insurance Research Association and were analyzed post hoc. Patients' data were included if the patients were ≥50 years old and diagnosed with osteoporosis and pathologic fracture, or osteoporosis therapy and fragility fracture by an International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) code designation, between 2008 and 2010.
The analysis included 830 patients (female: 77.3%; mean age: 73.4±9.8 years). The medians of the per-admission LOS and inpatient costs were 19 days and ¥18,587, respectively. Longer LOS and higher costs per admission were associated with older patients (≥70 years) compared to younger patients (<70 years). Hip fracture had the longest median LOS (22 days) and highest median cost (¥32,594) among all fracture sites. The per-hospitalization episode and per-day costs of osteoporotic fracture increased rapidly (60% and 89%, respectively) between 2008 and 2010.
The analysis showed that hospitalization cost increases were associated with increasing per-day hospitalization costs. The proportion of the costs reimbursed by health insurances increased, while the mean absolute patient copayment amounts decreased. The incidence and prevalence of osteoporosis and osteoporosis-related fractures may rise rapidly due to the projected growth of the aged population in mainland China. Therefore, the combination of greater anticipated total fractures and rising hospital costs may lead to a tremendously increased economic burden in the future.
本研究的目的是提供中国大陆地区骨质疏松相关骨折每次住院的住院费用及住院时长（LOS）的新估计值。
从全国性的中国健康保险研究协会获取与至少一处骨质疏松相关骨折的住院治疗数据，并进行事后分析。若患者年龄≥50岁，且在2008年至2010年间通过国际疾病分类及相关健康问题统计分类第10版（ICD - 10）编码确诊为骨质疏松和病理性骨折，或骨质疏松治疗及脆性骨折，则纳入患者数据。
分析纳入830例患者（女性：77.3%；平均年龄：73.4±9.8岁）。每次住院LOS的中位数和住院费用分别为19天和18587元。与年轻患者（<70岁）相比，老年患者（≥70岁）的LOS更长，每次住院费用更高。在所有骨折部位中，髋部骨折的LOS中位数最长（22天），费用中位数最高（32594元）。2008年至2010年间，骨质疏松性骨折的每次住院费用和每日费用增长迅速（分别为60%和8%）。
分析表明，住院费用增加与每日住院费用增加有关。医疗保险报销费用的比例增加，而患者平均绝对自付金额减少。由于中国大陆老年人口预计增长，骨质疏松及骨质疏松相关骨折的发病率和患病率可能迅速上升。因此，预计骨折总数增加和住院费用上升的综合情况可能导致未来经济负担大幅增加。
