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台灣髖部骨折之流行病學

The Epidermiology of Hip Fracture in Taiwan

摘要


本研究藉健保申報資料探討近年來國人髖部骨折之流行病學及其所耗費之醫療費用;流行病學分析包括發生率、性別、年齡、地區、季節及原因等。資料來源為1997年至2001年全民健康保險學術研究資料庫所提供之系統抽樣檔,取住院資料之醫療費用清單明細檔之資料,抽樣比例為5%;並根據國際疾病分類碼找出髖部骨折患者,利用SAS統計軟體予以分析。結果發現:在抽樣檔中,五年內髖部骨折個案數共計4497名,平均年發生率為82×10^(-5) (男性7l×10^(-5)、女性93×10^(-5))。隨著年齡上升,發生率亦上升,65歲以上年發生率達756×10^(-5)。在性別發生率上,在54歲以下以男性較高,多因交通事故而發生,55歲以上女性較高,墜落及跌倒為主要原因。若與各國50歲以上骨折人口比例比較,我國男性屬於發生率較高的地區,女性則較趨近中間值。髖部骨折平均年齡為70.8±17.2歲,女性(74.1±14.9歲)較男性為大(66.8±19.0歲)。各年齡層股骨頸骨折發生率小於股骨粗隆間骨折,女性隨著年紀增長,有股骨粗隆間骨折愈加增多的現象,男性則相反。股骨頸骨折平均年齡為71.9±15.8歲,略大於股骨粗隆間骨折之70.7±17.5歲。髖部骨折發生的時間和區域性,以一至三月發生率最高,而東部地區則是發生率最高的地區。我國健保每年花在髖部骨折之住院醫療費用為13億元,約佔所有骨折之1/5,其中復健費用小於1%。髖部骨折為一重要健康議題,耗用大量醫療資源,應加強相關之預防保健概念宣導。

並列摘要


The first aim of this study was to investigate the epidemiology of hip fracture in Taiwan from 1997 to 2001, including the sex-specific incidence rate, age-specific incidence rate, distribution of cases in different geographic areas and seasons, and the causes of fracture. The second aim was to show the medical cost of hip fracture during 1997 and 2001 in Taiwan. Cases with hip fracture were identified according to the coding of ICD-9-CM. There were 4497 hip fractures in the sampled data in Taiwan during 1997-2001. The average incidence was 82×10^(-5) per year (male 71×10^(-5)per year, female 93×10^(-5)per year). The age-specific rate increased steeply from 65 years old (y/o), and it was 756×10^(-5)per year in the population over 65 y/o. The incidence of hip fracture of male was higher in the population younger than 54 y/o, and higher in female in the population over 55 y/o. Compared with population over 50 y/o in other countries, the incidence of male in Taiwan was high, and that of female was about average. The average age of hip fracture was 70.8±17.2 y/o, and that of female (74.1±14.9 y/o) was higher than male (66.8±19.0 y/o). The incidence of femoral neck fracture was lower than intertrochanteric fracture. In female, the incidence of intertrochanteric fracture was getting more common with increasing age, and male showed reverse pattern. The average age of femoral neck fracture (71.9±15.8 y/o) was slight higher than intertrochanteric fracture (70.7±17.5y/o). The highest incidence occurred during January to March and eastern Taiwan. The yearly cost of hip fractures was 1.3 billions, accounted for about 1/5 of the total cost of hospitalized medical expense of all fractures, and the rehabilitative expense was less than 1%. Hip fracture is an important health-related issue, and the medical cost was so high that can not be ignored. We should emphasize the relevant issues of prevention and health promotion.

並列關鍵字

Hip fracture Medical cost Health Insurance

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