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Published in: Archives of Osteoporosis 1/2018

Open Access 01-12-2018 | Original Article

Incidence and risk factors of medical complications and direct medical costs after osteoporotic fracture among patients in China

Authors: Ruiqi Liu, Aijun Chao, Ke Wang, Jing Wu

Published in: Archives of Osteoporosis | Issue 1/2018

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Abstract

Summary

We analyzed the incidence of medical complications after osteoporotic fractures and estimated its risk factors and cost impacts. Osteoporotic fractures can result in lots of serious medical complications, which is associated with patients’ baseline characteristics such as patients’ disease history and significantly increased patients’ direct medical costs.

Purpose

The purpose of the study is to investigate the incidence and identify the risk factors of medical complications after osteoporotic fracture, and quantify patients’ economic burden.

Methods

Data were obtained from the Tianjin Urban Employee Basic Medical Insurance database (2009–2014). Patients aged ≥ 50 years, had ≥ 1 diagnoses of hip or vertebral fracture between 2010 and 2012, and continuously enrolled from 12 months before to 24 months after the first identified fracture were included. The incidence of medical complications was estimated within 12 months before and after fracture. Direct medical costs were measured and compared between patients with at least one medical complication and without any medical complications. Logistic regression was applied to identify risk factors for any medical complications.

Results

Three thousand seven hundred nineteen patients were identified; 45.0% had hip fracture, and 56.2% had vertebral fracture. After osteoporotic fracture, the accumulative incidence of the most common medical complications including constipation (25.6%, RR 1.38 [1.28, 1.48]), stroke (25.2%, 1.16 [1.09, 1.24]), pneumonia (17.0%, 1.55 [1.40, 1.73]), urinary tract infection (16.3%, 1.23 [1.12, 1.36]), and arrhythmia (11.8%, 1.39 [1.23, 1.56]) was significantly higher than that before fracture. Advanced age; male sex; retirement status; diagnosis of hypertension, chronic heart disease, cerebrovascular disease, hemiplegia, or Parkinson’s disease; and higher direct medical costs at baseline were significant predictors of complications. The all-cause direct medical cost during 24-month follow-up was $5665. Medical complications significantly increased patients’ direct medical costs.

Conclusions

Osteoporotic fractures led to amount of medical complications, which significantly increased patients’ economic burden. Complications correlate to various factors such as patients’ disease history.
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Metadata
Title
Incidence and risk factors of medical complications and direct medical costs after osteoporotic fracture among patients in China
Authors
Ruiqi Liu
Aijun Chao
Ke Wang
Jing Wu
Publication date
01-12-2018
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2018
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-018-0429-5

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