Abstract:

Objective To examine the current state of care services for geriatric osteoporotic fractures in Chinese hospitals and to provide a basis for the improvement of these services and the formulation of related policies. Methods In September to November 2023，a stratified convenience sampling method was used to investigate the implementation of care services for elderly patients with osteoporotic fractures in 621 hospitals across 31 provinces （autonomous regions and municipalities） in China. A self-designed questionnaire was utilized for this purpose. Results A total of 621 hospitals participated in the survey，with 432（69.57%） tertiary hospitals and 189（30.43%） secondary hospitals. Over 95% of hospitals provided health education on diet，medication，fall prevention，and early functional exercise for elderly fracture patients. Less than 80% of hospitals provide specialized training on osteoporosis treatment and secondary fracture prevention for medical staff. Only 263 hospitals（42.35%） routinely conduct bone density tests for patients over 50 years old with fractures，while 221 hospitals（35.59%） routinely conduct bone metabolic biochemical tests for such patients. Less than 50% of hospitals provide specialized services，such as geriatric osteoporotic fracture clinics，for elderly patients with osteoporotic fractures. Additionally，39.77% of hospital departments have not developed postoperative care plans for elderly patients with osteoporotic fractures. The lack of specialized care teams（91.63%），insufficient investment in care resources（88.08%），and the absence of policy support（77.45%） are identified as the primary factors impeding the provision of care services for elderly patients with osteoporotic fractures in hospitals. Although some care services in tertiary hospitals are superior to those in secondary hospitals（P<0.05），they are still far from adequate. Conclusion The development of care services for elderly patients with osteoporotic fractures in Chinese hospitals needs improvement. It is recommended to further standardize and enhance the content and methods of health education，intensify clinical assessments related to osteoporosis in elderly fracture patients，improve the professional care capabilities of medical staff，and at the same time，the state should introduce relevant policies to support and promote the construction and development of hospital care services for elderly osteoporotic fracture patients.

Key words: Osteoporotic Fractures, The Elderly, Nursing Care, Cross-Sectional Study

摘要：

目的 了解医院老年骨质疏松性骨折照护服务开展现况，为完善医院骨质疏松性骨折照护服务及制订相关政策提供依据。 方法 采用便利抽样法，于2023年9月—11月使用自行设计的问卷对31个省（自治区、直辖市）621所医院的老年骨质疏松性骨折照护服务开展情况进行调查。 结果 共621所医院完成调查，其中三级医院432所（69.57%）、二级医院189所（30.43%）。95.00%以上的医院对老年骨折患者进行饮食（98.55%）、用药（97.42%）、防跌倒（96.94%）、早期功能锻炼（96.62%）、骨质疏松（96.22%）等健康宣教；不足80.00%的医院对医护人员开展骨质疏松治疗（76.97%）和二次骨折预防（64.73%）相关专题培训；仅263所（42.35%）医院常规检查50岁以上骨折患者的骨密度，221所（35.59%）医院常规检查50岁以上骨折患者的骨代谢生化指标；200所（32.21%）医院开展老年骨质疏松性骨折专病门诊等特色服务，247所（39.77%）医院科室未制订老年骨质疏松性骨折患者的术后照护方案。缺乏专业照护团队（91.63%）、照护资源投入不足（88.08%）、缺乏政策支持（77.45%）被认为是阻碍开展相关照护服务的主要因素。三级医院部分照护服务开展优于二级医院（P<0.05）。 结论 医院老年骨质疏松性骨折照护服务开展有待完善，建议进一步规范和提升健康宣教内容与方式，加大老年骨折患者的骨质疏松相关临床评估力度，提升医护人员的专业化照护能力，同时应出台相关政策支持，促进医院老年骨质疏松性骨折照护服务的建设与开展。

关键词: 骨质疏松性骨折, 老年人, 护理, 横断面研究