| Objectives（1）To understand the utilization of inpatient health services and the economic burden of disease in patients with osteoporotic fractures;（2）To explore the influencing factors related to osteoporotic fractures;（3）To analyze the diagnosis and treatment,psychological and behavioral coping of patients with osteoporotic fractures（4）To develop a preliminary program of individualized psychological and behavioral remote intervention for patients with osteoporotic fractures.Methods（1）Use the literature review method and expert consultation method to obtain information on the influencing factors and intervention plan formulation of patients with osteoporotic fractures,and use structured questionnaires to conduct face-to-face surveys in three hospitals in Anhui Province from September 2021 to January 2022.Current patients over the age of 50 who were hospitalized with loose vertebral or hip fractures or radial fractures.The survey content included sociodemographic information,fracture site,physical activity,general behavior,status of family participation,etc.;the patient received information from the hospital after discharge Case data were recorded in the system,and information such as hospitalization,examination,and expenses of patients were collected;some patients were selected for qualitative interviews in the above three hospitals to find out the deficiencies of patients’ coping;（2）Use Epidata3.1 to establish questionnaires and case records The database was used for data entry,and SPSS 16.0was used for data analysis.Descriptive statistical analysis was used to analyze the socio-demographic information of the respondents,health service utilization of patients with osteoporotic fractures,behavior status of patients with osteoporotic fractures,status of environmental risk factors,and status of family participation.The Kruskal-Wakkis H test was used to analyze the differences in the composition of hospitalization costs for patients with different types of fractures;univariate analysis used variance analysis,multivariate analysis used multiple linear regression analysis and multivariate logistic regression analysis,and descriptive analysis was used for current status analysis.The way;（3）According to the above research results,according to the health belief model and the "Knowledge,Belief and Action" theory,formulate psychological and behavioral intervention programs for patients with osteoporotic fractures.Results（1）A total of 308 patients with osteoporotic fractures were investigated,including 111,147 and 50 patients with hip,cone and radius fractures respectively.248 patient medical records were completely extracted,and 30 inpatients with osteoporotic fractures were interviewed qualitatively;（2）The average total inpatient medical expenses of patients with hip,conical bone and radius fractures were 34,263.12 yuan,28,577.75 yuan,and 22,273.55 yuan respectively.All belong to catastrophic health expenditure;in the composition of hospitalization treatment expenses,the proportion of consumables expenses for hospitalized patients with three types of fractures is the highest;the difference in the composition of the average total hospitalization medical expenses for patients with different types of fractures is statistically significant;Statistically significant difference in the average length of hospital stay in patients with osteoporosis.（3）The results of univariate analysis showed that women’s family participation,activity environment,and health literacy were protective factors;high education level and urban residence were the protective factors for healthy eating habits scores;older age,high education level,long-term Living in a city and suffering from chronic diseases are protective factors for exercise scores;marital status is widowed,medical insurance type is urban workers,exercise scores are higher than other groups;insomnia/emotional coping scores are higher for 2 people living together Grouping;urban workers have higher insomnia/emotional coping scores than other groups;older age is a protective factor for the activity environment score,marital status is widowed,the activity environment score is the highest,and the place of residence is a city is a protective factor for the activity environment score,The medical insurance type is other activity environment,the highest score,chronic disease is the protective factor of activity environment score;patients with high education level have higher health literacy scores,and the marital status of widowed patients has the highest health literacy scores,living in cities,Suffering from chronic diseases is a protective factor for health literacy scores,and the medical insurance type is other health literacy scores;（4）The results of multivariate analysis showed that: multiple linear regression analysis showed that the absence of chronic diseases was a protective factor for the total score of family participation;high education level was a protective factor for healthy diet and total health literacy score;older age and high education level were the protective factors for physical exercise.The protective factors of the total score;the gender is female,the total score of the activity environment and health literacy is higher;the older the age,the higher the total score of the activity environment;the chronic disease has a higher health literacy score;multivariate logistic regression analysis shows that the score of family participation High is taking calcium tablets,eating vitamin D,not eating leftovers,choosing to walk or cycle rather than driving or using public transportation,etc.choosing ways to use more energy to complete your daily tasks,intentionally exercising Interspersed into your daily work or life,regularly reviewing and estimating sitting and lying time,changing sedentary work or recreation to standing or walking,sitting for more than 1 hour for work or recreation,intentionally interspersing alternative activities,engaging in Promoting factors for stretching or rotating arms,legs,and neck during long-term sedentary work or recreational activities;women are a driving factor for drinking milk and dairy products,and vitamin D consumption;chronic disease is a driving factor for drinking milk and dairy products,choosing to consume More energy way to complete daily tasks,regular review and estimation of sitting and lying time,changing sedentary work or play to standing or walking,sitting for more than 1 hour of work or play,intentionally interspersed with alternative activities,daily When you wake up,you exercise the protective factor of the joints of the whole body;high education level is the protective factor for the anti-skid function of the floor at home,and the protective factor for going out to do errands in rainy and snowy weather;older age is the bathroom（such as toilets,bathing places）not installed Handrails,passing through uneven roads,crowded crowds in daily activities or workplaces,stepping on stools to perform some daily activities,and protective factors for going out to do errands in rainy and snowy weather.Function,bathroom（such as toilet,bathing place）installation of handrails,the protection factor of bathroom installation anti-skid facilities;（5）Qualitative interviews found that some patients had insufficient awareness of osteoporosis and weak health awareness;most of the interviewees were exposed to high-risk fracture risk factors;patients had poor awareness of fracture prevention,and believed that fractures were inevitable,and most Patients do not know how to take specific measures to prevent fractures;most patients have varying degrees of negative emotions.Conclusions（1）Among inpatients with osteoporotic fractures,hip fracture patients have the highest total hospitalization expenses,and among the three types of fractures in hospitalized patients,the proportion of consumables expenses is always the highest,followed by treatment expenses,but diagnosis.The proportion of medical expenses,comprehensive medical service expenses,and drug expenses should not be ignored.The average hospitalization days of hip fracture patients is the largest,which needs to be paid attention to when formulating intervention measures.（2）The hospitalization medical expenses of patients with osteoporotic fractures are still very high,and the proportion of personal out-of-pocket expenses to per capita disposable income and the proportion of total medical expenses to per capita disposable income of patients with different types of osteoporotic fractures are the same.It constitutes a catastrophic health expenditure and brings a heavy economic burden to the patient’s family and society.（3）There are certain deficiencies and risks in the healthy diet,exercise,activity environment,family participation,insomnia/emotional coping of patients with osteoporosis,and the family participation,healthy diet,exercise,activity environment,The pitfalls and risks of health literacy and its general behavior differ and require targeted measures.（4）Osteoporosis patients have poor awareness of medical treatment,emotional coping,and prevention and treatment,and their existing psychological and behavioral coping deficits need to be improved.Psychological and behavioral interventions in patients with osteoporotic fractures. |
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