prevalence in 100,000 among men was 911.6 patients, among women 818.0 patients, in total 862.7. Average age of patients in outpatient care was 51.5 years, there was a significant difference (13.2 years) between men (45.0 years) and women (58.2 years). As regards sex distribution in outpatient care: 46.1% of patients were men, 53.9% were women, in general practice care men accounted for 54.7%, women for 45.3% of patients. Conclusions: Prevalence of injuries to the shoulder and upper arm was 1.11-times higher among men than among women. Prevalence in outpatient care was higher among men, in general practice care it was higher among women. Average age of women was 13.2 years higher than that of men.

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Összefoglaló. Bevezetés: A pertrochanter töréssel kapcsolatos szolgáltatások igénybevétele jelentős terhet jelent a társadalom és az egészségügyi rendszerek számára. Célkitűzés: Elemzésünk célja volt a pertrochanter törés okozta éves epidemiológiai és egészségbiztosítási betegségteher meghatározása Magyarországon. Adatok és módszerek: A felhasznált adatok a Nemzeti Egészségbiztosítási Alapkezelő (NEAK) finanszírozási adatbázisából származnak 2018. évre vonatkozóan. A betegszámok alapján meghatároztuk a 100 000 lakosra jutó prevalenciát, az éves egészségbiztosítási kiadásokat korcsoportos és nemenkénti bontásban. Az elemzésbe az érintett egészségbiztosítási ellátások teljes körét bevontuk. A pertrochanter töréseket a Betegségek Nemzetközi Osztályozása (BNO, 10. revízió) szerinti S7210-es kóddal azonosítottuk. Eredmények: A legnagyobb országos betegszámot a járóbeteg-szakellátás esetében találtuk: 2845 férfi, 6312 nő, együtt 9157 fő. Ezt követte az aktívfekvőbeteg-szakellátás (2388 férfi és 5858 nő, együtt 8246 fő). A valamennyi életkorra számított, 100 000 lakosra vetített prevalencia a férfiaknál 51,1 beteg, a nőknél 114,7 beteg, együtt 84,3 beteg volt az aktívfekvőbeteg-szakellátásban. A pertrochanter törés kezelésére 7,329 milliárd Ft-ot költöttek 2018-ban (27,12 millió USD, illetve 22,98 millió EUR). A kiadások 28,0%-a férfiaknál, 72,0%-a nőknél jelent meg. Az egészségbiztosítási kiadások 90,7%-a az aktívfekvőbeteg-szakellátásban jelentkezett. Az egy betegre jutó átlagos éves összesített egészségbiztosítási kiadás 858 710 Ft (3177 USD/2693 EUR) volt a férfiak és 901 047 Ft (3334 USD/2826 EUR) a nők esetében. Következtetés: A pertrochanter törés előfordulási gyakorisága 2,5-szer magasabb a nők esetében, mint a férfiaknál. Az aktívfekvőbeteg-szakellátás igénybevétele bizonyult a legfőbb költségtényezőnek. Orv Hetil. 2021; 162(Suppl 1): 46–53. Summary. Introduction: Health services utilization related to pertrochanteric fractures represents a significant burden for the society and health care systems. Objective: Our aim was to analyse the epidemiological and health insurance burden of pertrochanteric fractures in Hungary. Data and methods: Data were derived from the financial database of the National Health Insurance Fund Administration (NHIFA) of Hungary for the year 2018. The data analysed included annual patient numbers, prevalence per 100 000 population in acute inpatient care, health insurance costs calculated for age groups and sex for all types of care. Patients with pertrochanteric fracture were identified with the code S7210 of the International Classification of Diseases, 10th revision. Results: We found a significant patient turnover in outpatient care: 2845 men, 6312 women, in total 9157 patients, followed by acute inpatient care (2388 men, 5858 women, together: 8246 patients). Based on patient numbers in acute inpatient care, the prevalence per 100 000 among men was 51.1, among women 114.7, together 84.3 patients. In 2018, NHIFA spent 7.329 billion HUF (27.12 million USD, 22.98 million EUR) on the treatment of pertrochanteric fractures. 28.0% of the costs was spent on the treatment of male, 72.0% on female patients. Reimbursement of acute inpatient care was the main cost driver (90.7% of the total expenditure). The average annual treatment cost per patient was 858 710 HUF (3177 USD/2693 EUR) for men and 901 047 HUF (3334 USD/2826 EUR) for women. Conclusion: The prevalence of pertrochanteric fracture was 2.5 times higher in women compared to men. Acute inpatient care was the major cost driver in the treatment of pertrochanteric fracture. Orv Hetil. 2021; 162(Suppl 1): 46–53.

Objectives: Ongoing reforms to China's county-level public hospitals have generated an interest in developing evidence-based clinical pathways (CP). A pilot project in four counties has been embarked, linked with payment reform on cerebral infarction inpatient subjects. This study aimed to understand the impacts of the CP comprehensive intervention on treatment effectiveness and the use of resources. Methods: A retrospective observational study was conducted using de-identified data collected from four pilot sites. A mixed-methods approaches have been adopted to process the data analysis, including propensity score matching (PSM), interrupted time series (ITS) with segmented regression, and cost-effectiveness analysis (CEA). Prior to ITS analysis, the PSM was employed to ensure the similarity of baseline characteristics between pre and post groups. Then ITS analysis has been performed to describe the overall effects of the intervention on pre-defined outcomes. Afterwards, a CEA analysis has been developed using Markov model with the help of Treeage software, to calculate the incremental cost effectiveness ratio(ICER). Meanwhile, the probability sensitivity analysis (PSA) was performed to testify the influential factors. Results: Out of 2753 patients, 765 subjects were included after using the nearest neighbor PSM for age, gender, severity of disease, number of complications. The ITS analyses results showed that the advantage of CP intervention in term of average length of stay, total hospitalization expenses, medication costs, laboratory expenses, and quality-adjusted life years (QALY) estimated by EQ-5D. The ICER was 16756 RMB/QALY, which favored the choice of CP intervention compared to threshold. The PSA analysis showed that age, the number of days in hospital, and admittance of CP are the top three influential factors in sensitivity analysis. Conclusions: The evaluation findings and lessons learned from the pilots were widely discussed and disseminated to policy-makers to enable evidence-based decisionmaking for CP implementation in rural China.

prevalence in 100,000 among men was 911.6 patients, among women 818.0 patients, in total 862.7. Average age of patients in outpatient care was 51.5 years, there was a significant difference (13.2 years) between men (45.0 years) and women (58.2 years). As regards sex distribution in outpatient care: 46.1% of patients were men, 53.9% were women, in general practice care men accounted for 54.7%, women for 45.3% of patients. Conclusions: Prevalence of injuries to the shoulder and upper arm was 1.11-times higher among men than among women. Prevalence in outpatient care was higher among men, in general practice care it was higher among women. Average age of women was 13.2 years higher than that of men.