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中国老年人群体伤害的住院费用:分位数回归分析。

Hospitalization costs of injury in elderly population in China: a quantile regression analysis.

机构信息

College of Health Management, China Medical University, Shenyang, 110122, Liaoning, China.

Baotou Central Hospital, Baotou, 014040, Inner Mongolia, China.

出版信息

BMC Geriatr. 2023 Mar 14;23(1):143. doi: 10.1186/s12877-023-03729-0.

Abstract

BACKGROUND

Trauma in the elderly is gradually growing more prevalent as the aging population increases over time. The purpose of this study is to assess hospitalization costs of the elderly trauma population and analyze the association between those costs and the features of the elderly trauma population.

METHODS

In a retrospective analysis, data on trauma patients over 65 who were admitted to the hospital for the first time due to trauma between January 2017 and March 2022 was collected from a tertiary comprehensive hospital in Baotou. We calculated and analyzed the hospitalization cost components. According to various therapeutic approaches, trauma patients were divided into two subgroups: non-surgical patients (1320 cases) and surgical patients (387 cases). Quantile regression was used to evaluate the relationship between trauma patients and hospitalization costs.

RESULTS

This study comprised 1707 trauma patients in total. Mean total hospitalization costs per patient were ¥20,741. Patients with transportation accidents incurred the highest expenditures among those with external causes of trauma, with a mean hospitalization cost of ¥24,918, followed by patients with falls at ¥19,809 on average. Hospitalization costs were dominated by medicine costs (¥7,182 per capita). According to the quantile regression results, all trauma patients' hospitalization costs were considerably increased by length of stay, surgery, the injury severity score (16-24), multimorbidity, thorax injury, and blood transfusion. For non-surgical patients, length of stay, multimorbidity, and the injury severity score (16-24) were all substantially linked to higher hospitalization costs. For surgical patients, length of stay, injury severity score (16-24), and hip and thigh injuries were significantly associated with greater hospitalization costs.

CONCLUSIONS

Using quantile regression to identify factors associated with hospitalization costs could be helpful for addressing the burden of injury in the elderly population. Policymakers may find these findings to be insightful in lowering hospitalization costs related to injury in the elderly population.

摘要

背景

随着人口老龄化的不断增加,老年人创伤的发病率逐渐增高。本研究旨在评估老年创伤人群的住院费用,并分析这些费用与老年创伤人群特征之间的关系。

方法

本研究采用回顾性分析方法,收集了 2017 年 1 月至 2022 年 3 月期间,一家包头市三级综合医院首次因创伤住院的 65 岁以上老年创伤患者的数据。我们计算并分析了住院费用构成。根据不同的治疗方法,将创伤患者分为非手术患者(1320 例)和手术患者(387 例)两组。采用分位数回归评估创伤患者与住院费用的关系。

结果

本研究共纳入 1707 例创伤患者。每位患者的平均总住院费用为 20741 元。在创伤的外部原因中,交通伤患者的支出最高,平均住院费用为 24918 元,其次是跌倒伤患者,平均为 19809 元。住院费用主要由药品费用(人均 7182 元)构成。根据分位数回归结果,所有创伤患者的住院费用均随住院时间、手术、损伤严重程度评分(16-24 分)、合并症、胸部损伤和输血而显著增加。对于非手术患者,住院时间、合并症和损伤严重程度评分(16-24 分)与较高的住院费用显著相关。对于手术患者,住院时间、损伤严重程度评分(16-24 分)和髋部及大腿损伤与较高的住院费用显著相关。

结论

使用分位数回归识别与住院费用相关的因素有助于了解老年人群的创伤负担。决策者可能会发现这些发现有助于降低老年人群与创伤相关的住院费用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc2b/10015666/97f88bf110b8/12877_2023_3729_Fig1_HTML.jpg

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