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德国社会事故保险记录的与工作相关的骨盆和髋臼骨折的流行病学及社会经济后果

Epidemiology and socioeconomic consequences of work-related pelvic and acetabular fractures recorded in the German Social Accident Insurance.

作者信息

Hinz Nico, Dehoust Julius, Seide Klaus, Kowald Birgitt, Mangelsdorf Stefan, Frosch Karl-Heinz, Hartel Maximilian J

机构信息

Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Hospital Hamburg, Bergedorfer Strasse 10, 21033 Hamburg, Germany.

Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Hospital Hamburg, Bergedorfer Strasse 10, 21033 Hamburg, Germany.

出版信息

Injury. 2023 Aug;54(8):110848. doi: 10.1016/j.injury.2023.110848. Epub 2023 May 24.

Abstract

INTRODUCTION

Pelvic and acetabular fractures can result from work-related accidents and frequently require lengthy medical treatments. Consequently, high medical costs as well as delayed or absent return to work can be the consequence. Therefore, we aimed to study the socioeconomic consequences of work-related pelvic and acetabular fractures.

MATERIALS AND METHODS

This retrospective study investigated work-related pelvic and acetabular fractures recorded in the German Social Accident Insurance in 2011 and 2017, in terms of age, sex, type of accident, duration of incapacity to work, reductions in earning capacity, costs for outpatient and inpatient treatment and costs for pension and severance pay.

RESULTS

Among a total of 606 injuries in 2011 and 619 injuries in 2017, male patients and patients between 40 and 65 years were predominantly affected. Acetabular fractures caused higher rates of long absence from work of 6-12 months (2011: 24.7% vs. 9.5-16.9%; 2017: 26.1% vs. 6.1-11.0%) and >12 months (2011: 15.8% vs. 9.8-10.2%; 2017: 13.3% vs. 1.9-8.2%) as well as more cases with a reduction in earning capacity of at least 20% (2011: 61 vs. ≤27 cases; 2017: 39 vs. ≤12 cases) compared to pelvic ring fractures. The total costs for pelvic ring and acetabular fractures in the German social accident insurances amounted € 18,726,630 and € 9637,189 in the periods 2011-2020 and 2017-2020, respectively. The average costs per case for treatment and rehabilitation until 2020 was € 19,079 for injuries from 2011 and € 13,629 for injuries from 2017. Acetabular fractures were found to be the most cost-intensive injuries compared to anterior, posterior or complex pelvic ring fractures.

CONCLUSIONS

Work-related pelvic and especially acetabular fractures have a considerable socioeconomic impact in the German Social Accident Insurance. Measures to prevent work-related accidents and to improve treatment of pelvic injuries can help to reduce their socioeconomic burden.

摘要

引言

骨盆和髋臼骨折可能由工作相关事故导致,通常需要长时间的医学治疗。因此,可能会产生高昂的医疗费用以及工作延迟恢复或无法恢复的后果。所以,我们旨在研究工作相关骨盆和髋臼骨折的社会经济后果。

材料与方法

这项回顾性研究调查了2011年和2017年德国社会事故保险记录的工作相关骨盆和髋臼骨折,涉及年龄、性别、事故类型、丧失工作能力的持续时间、收入能力降低情况、门诊和住院治疗费用以及养老金和离职金费用。

结果

在2011年的606例损伤和2017年的619例损伤中,男性患者以及40至65岁的患者受影响最为显著。与骨盆环骨折相比,髋臼骨折导致6至12个月(2011年:24.7%对9.5 - 16.9%;2017年:26.1%对6.1 - 11.0%)和超过12个月(2011年:15.8%对9.8 - 10.2%;2017年:13.3%对1.9 - 8.2%)长期缺勤的比例更高,以及收入能力至少降低20%的病例更多(2011年:61例对≤27例;2017年:39例对≤12例)。在2011 - 2020年和2017 - 2020年期间,德国社会事故保险中骨盆环和髋臼骨折的总费用分别为18,726,630欧元和9,637,189欧元。截至2020年,2011年受伤的平均每例治疗和康复费用为19,079欧元,2017年受伤的为13,629欧元。与前侧、后侧或复杂骨盆环骨折相比,髋臼骨折被发现是费用最昂贵的损伤。

结论

工作相关骨盆骨折,尤其是髋臼骨折,在德国社会事故保险中具有相当大的社会经济影响。预防工作相关事故以及改善骨盆损伤治疗的措施有助于减轻其社会经济负担。

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