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中华关节外科杂志(电子版) ›› 2025, Vol. 19 ›› Issue (02) : 143 -150. doi: 10.3877/ cma.j.issn.1674-134X.2025.02.002

临床论著

髋膝关节置换术10年趋势的卫生经济学单中心分析
姚舜禹1, 樊沛2,(), 张波3, 祝杰生1   
  1. 1. 325000 温州医科大学
    2. 325000 温州医科大学附属第二医院
    3. 325000 温州医科大学附属第二医院质量管理处
  • 收稿日期:2024-04-13 出版日期:2025-04-01
  • 通信作者: 樊沛
  • 基金资助:
    温州市科学技术协会项目(KJFW2024-066)

Health economics single-center analysis of 10-year trends in hip and knee replacements

Shunyu Yao1, Pei Fan2,(), Bo Zhang3, Jiesheng Zhu1   

  1. 1. Wenzhou Medical University, Wenzhou 325000, China
    2. Wenzhou Medical University Affiliated Second Hospital, Wenzhou 325000, China
    3. Wenzhou Medical University Affiliated Second Hospital-Quality Management Department, Wenzhou 325000, China
  • Received:2024-04-13 Published:2025-04-01
  • Corresponding author: Pei Fan
引用本文:

姚舜禹, 樊沛, 张波, 祝杰生. 髋膝关节置换术10年趋势的卫生经济学单中心分析[J/OL]. 中华关节外科杂志(电子版), 2025, 19(02): 143-150.

Shunyu Yao, Pei Fan, Bo Zhang, Jiesheng Zhu. Health economics single-center analysis of 10-year trends in hip and knee replacements[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2025, 19(02): 143-150.

目的

本文分析近12年温州医科大学附属医院髋膝关节置换术的手术相关信息,以此为例反映近10年来关节置换术的手术趋势与卫生经济学趋势。

方法

本文通过收集统计温州医科大学附属医院2011年至2022年间行髋、膝关节置换患者的相关数据,包括患者年龄、性别、住院天数、主要诊断、手术名称、治疗费用等,比较其手术例数变化、患者年龄构成、性别差异、患者住院天数变化以及治疗相关费用,数据结果进行了t检验与logistic回归分析。

结果

本文研究了髋膝关节置换术共13 993例,其中髋关节置换术8 232例,膝关节置换术5 761例。在髋关节置换相关手术中,该院每年实行髋关节置换术例数逐年平均增长9.9%,患者平均年龄为(68±13)岁,男性患者占比42.2%,女性患者占比57.8%,患者平均住院时间较2011年减少46.7%,总治疗费用均值为53 936元,其中耗材费占比59.2%,总费用较2011年减少15.9%。在膝关节置换手术中,该院每年实行膝关节手术例数逐年平均逐年增长10.0%,患者平均年龄为(70±8)岁,男性患者占比30.4%,女性患者占比69.6%,患者平均住院时间较2013年减少41.5%,总治疗费用均值为48 559元,其中耗材费占比56.3%,总费用较2013年减少29.6%。

结论

行髋膝关节置换术的患者数量呈逐年上升趋势,虽然患者住院天数和住院费用较往年有了明显减少,但患者依然存在较大的治疗费用负担,降低手术的耗材费是降低总费用的重要环节。

Objective

To analyze the information related to hip and knee arthroplasty in a hospital affiliated to a medical university in the past 12 years, and take this as an example to reflect the surgical trend and health economic trend of joint arthroplasty in the past decade.

Methods

The data of patients undergoing hip and knee replacement in a hospital affiliated to a medical university from 2011 to 2022 were collected and analyzed, including patients’ age, gender, length of hospital stay, main diagnosis, name of operation, treatment cost, etc., and the changes in the number of operations, age composition of patients, gender differences, length of stay and treatment costs were compared. Statistical results were analyzed by t test and logistic regression analysis.

Results

A total of 13 993 cases of hip and knee arthroplasty were studied in this study, including 8 232 cases of hip arthroplasty and 5 761 cases of knee arthroplasty. In the hip arthroplasty related operations, the annul number of hip arthroplasty cases increased by an average of 9.9%, the average age of patients was (68±13)years, male patients accounted for 42.2% and female patients accounted for 57.8%. The average length of hospital stay of patients decreased by 46.7% compared with 2011. The average cost of total treatment was 53 936 yuan, of which the cost of consumables accounted for 59.2%. Total costs were 15.9% lower than the data in 2011. The annual number of knee surgery cases in the hospital increased by an average of 10.0% year by year, the average age of patients was (70±8) years, the proportion of male patients was 30.4%, and the proportion of female patients was 69.6%. The average length of hospital stay of patients was reduced by 41.5% compared with 2013, and the average total treatment cost was 48 559 yuan, of which consumables accounted for 56.3%. The total cost was 29.6% lower than in 2013.

Conclusions

The number of patients undergoing hip and knee replacement is increasing year by year. Although the hospitalization days and hospitalization costs of patients are significantly reduced compared with previous years, patients still have a large burden of treatment costs. Reducing the cost of surgical consumables is an important link to reduce the total cost.

图1 行髋膝关节置换术患者例数。图A为行髋关节置换术例数;图B为行膝关节置换术例数
Figure 1 Number of patients undergoing hip-knee arthroplasty. A shows the number of cases of hip arthroplasty; B shows the number of knee arthroplasty
图2 行髋膝关节置换术患者年龄分布图。图A为髋关节置换术患者年龄分布;图B为膝关节置换术患者年龄分布
Figure 2 Age distribution of patients undergoing hip-knee arthroplasty. A is age distribution of patients undergoing hip arthroplasty; B is age distribution of patients undergoing knee arthroplasty
图3 手术患者年龄与例数变化图。图A为行全髋关节置换术患者年龄与例数变化;图B为行人工股骨头置换术患者年龄与例数变化;图C为全膝关节置换术患者年龄与例数变化
Figure 3 Age and number of patients undergoing surgery. A shows the age and number of patients undergoing total hip arthroplasty; B shows the age and number of patients undergoing artificial femoral head arthroplasty; C shows the age and number of patients undergoing total knee arthroplasty
图4 髋膝关节置换术后患者住院天数变化。图A为髋关节术后;图B为膝关节术后
Figure 4 Length of hospital stay after hip-knee arthroplasty. A is the hospital stay change of hip arthroplasty; B is the hospital stay length change of knee arthroplasty
图5 髋膝关节置换术后不同住院天数患者人数分布图
Figure 5 Distribution of patients with different hospitalization days after hip-knee arthroplasty
图6 髋膝关节置换术总费用与耗材费及变化趋势。图A为髋关节置换术;图B为膝关节置换术
Figure 6 Total cost and consumables cost of hip-knee arthroplasty and their changing trend. A shows hip arthroplasty; B shows knee arthroplasty
表1 髋膝关节置换相关手术患者基本资料对比
Table 1 Comparison of basic data of patients undergoing hip/knee replacement surgery
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