澳大利亚新南威尔士州老年髋部骨折患者医院获得性并发症对住院时间和费用的影响。
Effect of hospital-acquired complications on hospital length of stay and cost for older adults after a hip fracture in New South Wales, Australia.
作者信息
Mitsutake Seigo, Lystad Reidar P, Okuba Tolesa, Long Janet C, Braithwaite Jeffrey, Hirata Takumi, Mitchell Rebecca
机构信息
Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia.
Human Care Research Team, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-Cho, Itabashi-Ku, Tokyo, 173-0015, Japan.
出版信息
Osteoporos Int. 2025 Jun 16. doi: 10.1007/s00198-025-07536-8.
UNLABELLED
For older adults following a hip fracture who had hospital-acquired complications (HACs), hospital length of stay (LOS) and costs were over 40% higher compared to those without HACs. Improving strategies for preventing HACs among older adults after a hip fracture would contribute towards a sustainable healthcare system for an aged society.
PURPOSE
Although HACs can result in a high financial burden for health systems, little is known about the effect of common HACs on hospital LOS and cost among older adults after a hip fracture. This study examined the effect of HACs on hospital LOS and cost among older adults after a hip fracture.
METHODS
This retrospective cohort study used linked hospitalisation and mortality data in New South Wales, Australia, between 2013 and 2022. Older adults who were admitted after a hip fracture and discharged between July 2014 and June 2022 were identified. A 1:1 matched design was used to determine hospital LOS and care costs between older patients with and without HACs.
RESULTS
Among 41,013 older patients hospitalised after a hip fracture, 14,050 (34.3%) experienced a HAC. The most common complication was healthcare-associated infections (43.1%). After matching, patients with HACs had a longer hospital LOS (median 31 days, IQR 17-47 days) compared to patients without HACs (median 22 days, IQR 9-35 days) (P < 0.001). Patients with HACs had higher hospital costs (median $84,779, IQR $44,296-$131,426) than patients without HACs (median $60,137, IQR $23,995-$100,300) (P < 0.001). For patients with HACs, hospital LOS was 43% longer (95% confidence interval (CI): 1.41-1.46), and hospital costs were 42% higher (95% CI: 0.40-0.44) compared to those without HACs.
CONCLUSIONS
Implementing strategies for preventing HACs among older adults after a hip fracture would contribute towards a sustainable healthcare system as HACs are potentially preventable.
未标注
对于髋部骨折后出现医院获得性并发症（HACs）的老年人，其住院时间（LOS）和费用比未出现HACs的老年人高出40%以上。改善髋部骨折后老年人预防HACs的策略将有助于建立一个适用于老龄化社会的可持续医疗体系。
目的
尽管HACs会给卫生系统带来高昂的经济负担，但对于常见HACs对髋部骨折后老年人住院时间和费用的影响知之甚少。本研究探讨了HACs对髋部骨折后老年人住院时间和费用的影响。
方法
这项回顾性队列研究使用了2013年至2022年澳大利亚新南威尔士州的住院和死亡数据。确定了2014年7月至2022年6月期间髋部骨折后入院并出院的老年人。采用1:1匹配设计来确定有和没有HACs的老年患者之间的住院时间和护理费用。
结果
在41013名髋部骨折后住院的老年患者中，14050名（34.3%）出现了HACs。最常见的并发症是医疗相关感染（43.1%）。匹配后，与没有HACs的患者相比，有HACs的患者住院时间更长（中位数31天，四分位间距17 - 47天）（中位数22天，四分位间距9 - 35天）（P < 0.001）。有HACs的患者住院费用（中位数84779美元，四分位间距44296 - 131426美元）高于没有HACs的患者（中位数60137美元，四分位间距23995 - 100300美元）（P < 0.001）。对于有HACs的患者，与没有HACs的患者相比，住院时间长43%（95%置信区间（CI）：1.41 - 1.46），住院费用高42%（95% CI：0.40 - 0.44）。
结论
由于HACs具有潜在的可预防性，因此实施髋部骨折后老年人预防HACs的策略将有助于建立一个可持续的医疗体系。
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