[Costs due to osteoporosis-induced fractures in The Netherlands; possibilities for cost control]

Abstract

Objective: Evaluation of the medical costs of osteoporotic fractures in the Netherlands and a discussion of the possibilities of cost control.

Design: Cost calculation using published data combined with data from routine hospital and nursing home registration.

Setting: The Netherlands.

Methods: We estimated the total cost of osteoporosis related to fractures of the hip, forearm and vertebrae. Incidence data and data from hospital and nursing home stays were related to information about costs. The analysis was performed for men and women aged 50 and older based on data from 1993. The validity of the assumptions was tested in a sensitivity analysis.

Results: The direct medical cost of osteoporosis-related fractures was estimated to be over 400 million builders each year. More than one-third of this cost originated in the group aged 85 and over, while this group only represented 1.3% of the population. About 85% of the costs were caused by hip fractures. Of those costs of hip fractures 80% was due to the hospital admissions. The length of stay in the hospital was associated with discharge status (the length of stay for patients going to a nursing home was almost 8 days longer than for patients leaving for their own homes) and age (the length of stay increased by 0.3 days/year of age). The cost of the stay in a nursing home and of ambulatory care were 20% and 10%, respectively, of the total costs.

Conclusion: In the short term, cost control is mainly possible by reducing the length of stay in the hospital. This can be done by providing better methods of discharge to suitable care facilities. The cost-effectiveness of prevention of fractures is at present unclear. Due to the duration of the treatment and the frequency of fractures at high ages, the timing of the intervention is of great importance.