Long-term trends of osteoporotic hip fractures in South Korea: analysis of National Health Insurance Data from 2006 to 2022

Abstract

This study analyzed 16-year hip fracture trends in South Korea. Hip fractures increased with an aging population but plateaued after 2010. Mortality declined from 18.9 to 15.4% before rising to 18.2% on 2021. Subsequent fracture rates remained stable, underscoring the need for targeted prevention, especially during COVID-19.

Purpose: There are no data reporting long-term trends of hip fractures over 15 years based on the national population in South Korea. This study aimed to analyze the long-term trends of hip fractures from 2006 to 2022 using a nationwide claims database.

Methods: Data managed by the Korean National Health Insurance Service (NHIS) were used to identify hip fractures in patients aged 50 or older. Long-term trends in the incidence, mortality rate, and subsequent fractures during this period were analyzed.

Results: The incidence rates of hip fractures increased by 138% (from 152 to 173 per 100,000) from 2006 to 2010, then plateaued. The 1-year mortality rate decreased from 18.9% in 2006 to 15.4% in 2018 but increased to 18.2% in 2021. Lower socioeconomic groups had consistently higher incidence and mortality rates throughout the study period. The rates of subsequent fractures remained stable at 1.0-1.2% between 2006 and 2018 but decreased to 0.8-0.9% between 2019 and 2021.

Conclusions: Over the past 16 years, the number of hip fractures in South Korea has continued to rise with the aging population, though the incidence rate has recently plateaued. The mortality rate has decreased over time, and the rates of subsequent fractures have remained stable, albeit with some impact during the COVID-19 period (2019-2021). These findings provide valuable insights into the 16-years epidemiological trends of hip fractures in South Korea.

Keywords: Aging; Epidemiology; General population studies; Orthopedics; Osteoporosis.