Jingushi Seiya, Fukuda Haruhisa
Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Kitakyushu, Japan.
Department of Health Care, Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
J Orthop Sci. 2021 Sep;26(5):865-869. doi: 10.1016/j.jos.2020.08.015. Epub 2020 Dec 9.
The national database of health insurance claims of Japan (NDB) includes almost all health insurance claims in Japan. Currently, we have many cases of geriatric fracture in Japan, probably due to an increase of the elderly population. The increase of geriatric fractures may influence the use of low-intensity pulsed ultrasound (LIPUS), which is used to accelerate the fracture repair process. The present state of LIPUS treatments was analyzed using the large dataset of the NDB.
The open data from the NDB that were used included receipts from April 2015 to March 2016. The total numbers of fracture treatments were counted as the sum of the claim items that were involved in fracture treatments. Two types of the insurance claim items for LIPUS treatments were counted separately: those used for delayed or non-union fractures; and those used for fractures within two weeks after osteosynthesis. Additionally, the ratio of the LIPUS treatments per the fracture treatments was calculated.
In female patients, the number of LIPUS treatments for fractures early after osteosynthesis showed a large peak in the senile generation. Additionally, the ratio of LIPUS treatments early after osteosynthesis to all osteosynthesis treatments tended to increase with age in both males and females, while the ratio of the LIPUS treatments for delayed or non-union fractures to all fracture treatments decreased with age.
LIPUS treatments were frequently used to treat fractures early after osteosynthesis in elderly patients, probably due to the large number of fractures in the elderly population. Additionally, the ratio of LIPUS treatments early after osteosynthesis was high in both elderly female and elderly male patients, suggesting that there is a demand for early fracture repair.
日本全国健康保险理赔数据库（NDB）涵盖了日本几乎所有的健康保险理赔记录。目前，日本存在许多老年骨折病例，这可能是由于老年人口增加所致。老年骨折病例的增多可能会影响低强度脉冲超声（LIPUS）的使用，LIPUS用于加速骨折修复过程。本研究利用NDB的大型数据集分析了LIPUS治疗的现状。
使用的NDB开放数据包括2015年4月至2016年3月的收据。骨折治疗的总数按骨折治疗所涉及的理赔项目总和计算。LIPUS治疗的两种保险理赔项目分别计算：用于延迟愈合或不愈合骨折的项目；以及用于骨合成后两周内骨折的项目。此外，还计算了LIPUS治疗占骨折治疗的比例。
在女性患者中，骨合成后早期骨折的LIPUS治疗次数在老年人群中出现了一个大峰值。此外，骨合成后早期LIPUS治疗占所有骨合成治疗的比例在男性和女性中均随年龄增长而趋于增加，而延迟愈合或不愈合骨折的LIPUS治疗占所有骨折治疗的比例则随年龄增长而下降。
LIPUS治疗常用于老年患者骨合成后早期的骨折治疗，这可能是由于老年人群中骨折数量众多。此外，老年女性和老年男性患者骨合成后早期LIPUS治疗的比例都很高，这表明对早期骨折修复存在需求。
