骨質疏鬆相關骨折住院病患之健保申報分析

National Health Insurance Data in Hospitalized Patients with Osteoporosis-related Fractures

10.6320/FJM.2007.11(1).04

李瑋君(Wei-Chun Li)；韓岳津(Yueh-Chin Han)；吳英黛(Ying-Tai Wu)；曹昭懿(Jau-Yih Tsauo)

骨質疏鬆 ； 骨折 ； 健康保險 ； osteoporosis ； fracture ； health insurance

台灣醫學

11卷1期（2007 / 01 / 01）

22 - 28

繁體中文

藉由逐年資料分析，了解台灣因骨質疏鬆最常發生的三個骨折部位住院之病患，耗用醫療及健保資源的趨勢。資料來源為1996至2003年全民健康保險學術研究資料庫所提供住院特定檔之住院醫療費用清單明細檔。選取年齡大於等於50歲之女性與大於等於65歲之男性住院病患，主診斷為骨質疏鬆病患最常見的三個骨折部位者（腕部、髖部及脊椎）；分析不同之性別、年齡、骨折部位者，其住院花費與住院天數，以描述性統計為主。不論男女每年發生骨折住院的人次有逐年增加的趨勢，然佔同年齡層人口數之比例各年間並無顯著差異，男女分別為0.51%~0.65%及0.55%~0.66%。隨年齡的增加此一住院比例會隨之增加；而各年齡層女性約為男性的兩倍。各骨折部位中以髖部骨折佔最多。在住院花費方面，平均每年每一人次住院花費均在46,000-50,000間，而住院天數則有逐年減少之趨勢，自1996年6.6-14.2日至2003 年3.8-9.9日（約減少30-40%）。台灣老年人口持續增加，骨質疏鬆症病患亦將逐年增加，若不預防骨質疏鬆相關之骨折，勢必對台灣社會醫療造成極大的負擔。

Purposes: This study was designed to investigate the hospitalization of patients with three common sites of osteoporosis-related fractures in Taiwan, and their cost from 1996 to 2003. Methods: We used the inpatient expenditures by admissions data files (DD files) offered by National Health Research Institutes (NHRI) in the years of 1996-2003. The population consisted of males older than 65 years old and females older than 50 years old. Cases with three common sites of osteoporosis-related fractures (proximal part of lower extremity, distal part of upper extremity, and spine) were identified according to the coding of International Classification of Diseases, 9th Revision (ICD-9-CM). Descriptive statistics was used to show the mean cost per case for each hospitalization, total cost and length of stay among different genders, age groups and fracture sites. Results: Hospitalized fractured subjects at these 3 sites increased year by year, the rates of males and females were 0.51%~0.65% and 0.55%~0.66% respectively. The rate increased with age; in the same age groups, the rate of females is about two fold of the rate of males. The most common fracture site was hip. The mean cost per case of the hospitalizations was between NTD 46,000 and 50,000. The mean length of stay reduced year by year, the length of stay was 6.6~14.2 days and 3.8~9.9 days respectively from 1996 to 2003, reduced approximately 30-40%. Conclusion: In Taiwan, the number of osteoporosis-related fracture is still rising because of an aging population, inevitably it will be an enormous burden of the society.