Hektoen Liv Faksvåg, Saltvedt Ingvild, Sletvold Olav, Helbostad Jorunn L, Lurås Hilde, Halsteinli Vidar
1 Faculty of Health Sciences, Department of Physiotherapy, Oslo and Akershus University College of Applied Sciences, Norway.
2 St Olav Hospital, Trondheim University Hospital, Norway.
Scand J Public Health. 2016 Dec;44(8):791-798. doi: 10.1177/1403494816674162. Epub 2016 Oct 23.
The aim of this study was to estimate the one-year health and care costs related to hip fracture for home-dwelling patients aged 70 years and older in Norway, paying specific attention to the status of the patients at the time of fracture and cost differences due to various patient pathways after fracture.
Data on health and care service provision were extracted from hospital and municipal records and from national registries; data on unit costs were collected from the municipalities, hospital administrations and previously published studies. Four different patient pathways were identified and the total costs for subgroups of patients according to age, sex, fracture type and instrumental activity of daily living at fracture incidence were calculated. Descriptive statistics were used to identify cost estimates.
The mean total one-year costs per patient were EUR 68,376 and the costs for patients alive one year after hip fracture were EUR 71,719. The patients' age and pre-fracture functional status contributed most to the total cost.
On average, care costs accounted for more than 50% of the total cost; even for patients with good functional status before hip fracture, care costs accounted for 40% of the total cost compared with hospital costs of 38%. To reduce the financial costs of hip fractures in the care sector, the results point to the importance of preventive programmes to reduce the risk of hip fracture, but also to the importance of comprehensive geriatric care in the initial phase after a hip fracture.
本研究旨在估算挪威70岁及以上居家髋部骨折患者的一年健康和护理成本，特别关注骨折时患者的状况以及骨折后不同患者就医路径导致的成本差异。
从医院和市政记录以及国家登记处提取健康和护理服务提供的数据；从市政当局、医院管理部门和先前发表的研究中收集单位成本数据。确定了四种不同的患者就医路径，并计算了根据年龄、性别、骨折类型和骨折发生时日常生活工具性活动划分的患者亚组的总成本。使用描述性统计来确定成本估算。
每位患者一年的平均总成本为68376欧元，髋部骨折后存活一年的患者成本为71719欧元。患者的年龄和骨折前功能状态对总成本的影响最大。
平均而言，护理成本占总成本的50%以上；即使是髋部骨折前功能状态良好的患者，护理成本也占总成本的40%，而医院成本占38%。为降低护理部门髋部骨折的财务成本，结果表明预防计划对于降低髋部骨折风险的重要性，同时也表明髋部骨折后初始阶段综合老年护理的重要性。
