Health Care Resource Utilization And Direct Medical Costs For Patients With Osteoporotic Fractures

Objectives: To estimate annual health care resource utilization and direct medical costs for patients with osteoporotic fractures in Tianjin,China.Methods: Data were obtained from Tianjin Urban Employee Basic Medical Insurance database(2008-2011).Patients who ≥50 years old,with ≥1 diagnosed of osteoporotic fractures between January 1st,2009 to December 31 st,2010,and 12-month continuous enrollment before(baseline)and after(follow-up)the first observed osteoporotic fracture diagnosis were identified.Both osteoporosis-related and all-cause health care resource utilization and direct medical costs were estimated during the 12-month follow-up period.Ordinary least square regression model was applied to identify factors associated with the inpatient length of stay(LOS)and direct medical costs.Results: A total of 5941 patients were included,with mean age of 65.9(±10.5)years,62.1% female,and 88.2% retired.Annual mean all-cause costs were 16845 CNY per patient with osteoporosis-related costs accounting for 53.8%.For osteoporosis-related health services,33.2% of patients experienced ≥1 hospitalization with mean length of stay of 18.0(±14.4)days and mean cost of 19897 CNY per admission,and 83.2% of patients experienced ≥1 outpatient visit with mean(±SD)number of visits 7.4(±8.7)and mean cost 104 CNY per visit.The medical device costs were the largest component(38.5%)of osteoporosis-related costs,followed by drug costs(31.1%)and examination costs(11.7%).The LOS regression models revealed that older patients,patients with more comorbidity and patients with hip and lower limb fractures had longer osteoporosis-related LOS.The cost regression model revealed that osteoporosis-related costs tended to increase with age,patients with hip,vertebral,lower leg and multiple fractures were more likely to have a higher cost.Conclusions: Cost for patients with osteoporotic fractures was considerable,mainly driven by osteoporotic fracture hospitalizations.Efforts focused on reducing the utilization of inpatient services and increasing efforts to lower the fracture risks may have the potential to lighten the economic burden of osteoporotic fractures in China.