Department of Geriatric Medicine and Palliative Care, Badalona Serveis Assistencials, Catalonia, Spain; Universitat Autònoma de Barcelona, Medicine Department, Catalonia, Spain; Catalonia Geriatrics and Gerontology Society, Catalonia, Spain.
Unitat d'Informació i Coneixement, Servei Català de la Salut, Catalonia, Spain.
J Am Med Dir Assoc. 2019 Apr;20(4):456-461. doi: 10.1016/j.jamda.2018.08.005. Epub 2018 Oct 1.
To assess the impact of hip fracture (HF) on health care expenditures and resource use.
Observational, retrospective study. An administrative registry was used to obtain sociodemographic, clinical, and expenditure data of patients treated in centers all over Catalonia (North-East Spain).
Male and female patients aged 65 years or older admitted to a Catalonian hospital due to hip fracture (HF) between January 1 2012, and December 31, 2016.
The study data set included the expenditure and frequency of using nonemergency transport, rehabilitation, skilled nursing facility, specialist visits, admissions to the emergency department, hospitalization, pharmacy, and primary care. The patient status at each time point included living at home, staying in hospital, staying in a skilled nursing facility, institutionalized in a nursing home, and death.
The record included 38,628 patients (74.4% female) with a mean [standard deviation (SD)] age of 84.9 (7.07) years. The average expenditure per patient during the first year after hospital admission was €11,721.06, the index hospitalization being the leading expenditure (€4740.29). Expenditures related to hospitalization and skilled nursing facility remained higher than preinjury throughout the 3 years following HF. Three years after the index admission, 44.9% of patients had died, 39.7% were living in their homes, 14.2% were in a nursing home, 0.9% were in a skilled nursing facility, and 0.3% were in hospital. The expenditure of hospitalizations, primary care, and visits to the emergency department increased few months before the HF.
In patients hospitalized for HF, the expenditure per patient decreases after hospital discharge but the use of healthcare resources is not restored to preinjury values. The increase of expenditures associated with primary care services, hospitalization, and emergency department services during the few months preceding hospital admission suggests a decline of health status in these patients.
评估髋部骨折（HF）对医疗保健支出和资源利用的影响。
观察性、回顾性研究。使用行政登记处获取在加泰罗尼亚各地中心接受治疗的患者的社会人口统计学、临床和支出数据。
2012 年 1 月 1 日至 2016 年 12 月 31 日因髋部骨折（HF）入住加泰罗尼亚医院的 65 岁及以上的男性和女性患者。
研究数据集包括非紧急交通、康复、熟练护理设施、专科就诊、急诊就诊、住院、药房和初级保健的支出和使用频率。每个时间点的患者状态包括居家生活、住院、入住熟练护理设施、机构化护理院和死亡。
记录包括 38628 名患者（74.4%为女性），平均年龄为 84.9（7.07）岁。入院后第一年每位患者的平均支出为 11721.06 欧元，索引住院是主要支出（4740.29 欧元）。在 HF 后 3 年内，与住院和熟练护理设施相关的支出仍高于受伤前。索引入院 3 年后，44.9%的患者死亡，39.7%的患者居家生活，14.2%的患者居住在养老院，0.9%的患者居住在熟练护理设施，0.3%的患者住院。HF 前几个月，住院、初级保健和急诊就诊的支出增加。
在因 HF 住院的患者中，出院后每位患者的支出减少，但医疗资源的使用并未恢复到受伤前的水平。与初级保健服务、住院和急诊部门服务相关的支出在入院前几个月增加表明这些患者的健康状况下降。
