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Osteoporosis International
Published in: Osteoporosis International 11/2015

01-11-2015 | Original Article

The burden of osteoporotic hip fractures in Portugal: costs, health related quality of life and mortality

Authors: A. Marques, Ó. Lourenço, J. A. P. da Silva, on Behalf of the Portuguese Working Group for the Study of the Burden of Hip Fractures in Portugal

Published in: Osteoporosis International | Issue 11/2015

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Abstract

Summary

The study rationale was to provide a detailed overview of the costs, quality of life and mortality of hip fractures in Portugal. Mean individual fracture-related costs were estimated at €13,434 [12,290; 14,576] for the first year and €5985 [4982; 7045] for the second year following the fracture.

Introduction

Osteoporotic fractures represent a remarkable burden to health care systems and societies worldwide, which will tend to increase as life expectancy expands and lifestyle changes favour osteoporosis. The cost-effectiveness evaluation of intervention strategies demands accurate data on the epidemiological and economical reality to be addressed.

Methods

Information was collected retrospectively on consumption of resources and changes in quality of life attributable to fracture as well as mortality, regarding 186 patients randomly selected to represent the distribution of hip fractures in the Portuguese population, in terms of gender, age and geographical provenience. Data were cross-tabulated with socio-demographic variables and individual resource consumption to estimate the burden of disease. A societal perspective was adopted, including direct and indirect costs. Multivariate analyses were carried out to assess the main determinants of health-related quality of life (HrQoL).

Results

Mean individual fracture-related costs were estimated at €13,434 [12,290; 14,576] for the first year and €5985 [4982; 7045] for the second year following the fracture. In 2011 the economic burden attributable to osteoporotic hip fractures in Portugal could be estimated at €216 million. Mean reduction in HrQoL 12 months after fracture was estimated at 0.34. Regression analysis showed that age was associated with a higher loss of HrQoL, whereas education had the opposing effect. We observed 12 % excess mortality in the first year after hip fracture, when compared to the gender and age-matched general population.

Conclusions

Results of this study indicate that osteoporotic hip fractures are, also in Portugal, despite its low incidence of fractures and cost per event, associated with a high societal burden, in terms of costs, loss in HrQoL and mortality. These data provide valuable input to the design and selection of fracture prevention strategies.
Appendix
Available only for authorised users
Footnotes
1
€2500 corresponds to the comprehensive cost of inpatient care to treat a hip fracture. Table 1 shows the source of this figure.
 
2
€20,000 corresponds approximately to the upper 95 % confidence interval for Sweden [7], assuming the replacement costing method.
 
3
[13] refers that and estimate of the SD can be found by computing the range divided by 4.
 
4
€ 800 is approximately equivalent to 5 % of the mean cost of hip fracture in Sweden [7] assuming the replacement cost method
 
5
The sample size estimation accounted for fact that we are extracting a random sample from a finite population.
 
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Metadata
Title
The burden of osteoporotic hip fractures in Portugal: costs, health related quality of life and mortality
Authors
A. Marques
Ó. Lourenço
J. A. P. da Silva
on Behalf of the Portuguese Working Group for the Study of the Burden of Hip Fractures in Portugal
Publication date
01-11-2015
Publisher
Springer London
Published in
Osteoporosis International / Issue 11/2015
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-015-3171-5

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