Epidemiology and economic burden of fragility fractures in Austria

Abstract

Fragility fractures are a frequent and costly event. In Austria, 92,835 fragility fractures occurred in patients aged ≥ 50 years in 2018, accruing direct costs of > 157 million €. Due to demographic aging, the number of fragility fractures and their associated costs are expected to increase even further.

Introduction: Fragility fractures are frequently associated with long hospital stays, loss of independence, and increased need for care in the elderly, with consequences often leading to premature death. The aim of this study was to estimate the number of fragility fractures and associated healthcare costs in Austria in 2018.

Methods: The number of in-patient cases with relevant ICD-10 diagnoses in all Austrian public hospitals was derived from discharge documentation of diagnoses and procedures covering all public hospitals in Austria. Fractures resulting from falls from standing height in patients aged ≥ 50 years were used as a proxy for fragility fractures, and the number of in-patient and out-patient cases was estimated. The direct costs of these cases were calculated using the average cost of the corresponding in-patient hospital stay and the average cost for the out-patient stay.

Results: The present study estimated the number of fragility fractures (pelvis, thoracic and lumbar vertebra, hip, humerus, rib, forearm, and tibia) for 2018 at 92,835 or just over half of all fractures in patients aged ≥ 50 years, corresponding to a prevalence of 2,600 per 100,000 inhabitants of this age group. A constant increase in the proportion of fragility fractures among all fractures was observed with increasing age in both men and women. These fractures amounted to direct costs of > 157 million €.

Conclusion: Fragility fractures are a frequent and costly event in Austria. Due to the aging of the population, the number of fragility fractures and their associated costs is expected to increase even further.

Keywords: Burden of disease; Fragility fractures; Healthcare costs; Low-trauma fractures; Osteoporosis.

Fig. 1

Fragility fractures across all age groups. A Percentage of fragility fractures among all fractures in the in-hospital setting in 2018, by sex and age (N = 39,147 in-hospital cases with documented falls from standing height) (a). a The figure covers in-patient cases only, since data on diagnosis is not available in the out-patient sector. B Incidence of fragility fractures per 100,000 inhabitants in 2018, by sex and age (N = 115,309 in-patient and out-patient cases with falls from standing height) (b). b Incidence calculations are based on a population of 8,822,267 inhabitants in 2018, 4,338,518 men and 4,483,749 women [6]

Fig. 2

Healthcare costs associated with fragility fractures in patients aged 50 years or older, by treatment setting, sex, and fracture site. A In-patient setting. B Out-patient setting

Fig. 3

Fragility fractures in patients aged 50 years or older, by sex and fracture site (N = 92,835 in- and out-patients)