Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Archives of Osteoporosis
Published in: Archives of Osteoporosis 1/2021

01-12-2021 | Osteoporosis | Original Article

Sociodemographic and health system factors associated with variations in hospitalization costs for fractures in adults aged 45 years and over: a cross-sectional study of provincial health accounts in Jiangsu Province, China

Authors: Lizheng Xu, Stephen Jan, Mingsheng Chen, Lei Si

Published in: Archives of Osteoporosis | Issue 1/2021

Login to get access

Abstract

Summary

This study reports hospitalization costs of fracture in Chinese patients aged over 45 years and evaluates their related factors in different fracture groups.

Purpose

To report hospitalization costs of treating fractures in Chinese patients aged over 45 years and to investigate the sociodemographic and health system factors related to variation in the costs.

Methods

Study participants were selected from the 2016 Health Accounts Database in Jiangsu in which patients’ hospitalization costs were kept at various levels in hospitals. A multi-stage stratified sampling method was used to select study participants. Electronic medical records of patients aged 45 years and over with fractures were included. The International Classification of Diseases, Tenth Revision (ICD-10) was used to identify patients who were hospitalized due to fractures. A generalized linear model was used to estimate the extent to which a range of health system and sociodemographic factors were associated with the variation on hospitalization costs. Costs data were presented and analyzed using 2016 U.S. dollars.

Results

A total of 39,300 patients were included in the study. Vertebra, tibia/fibula, and hip were the most frequent fracture sites. The mean (median) of hospitalization cost of included fractures ranged from USD 3142 (USD 2420) for hand and wrist fractures to USD 10,355 (USD 9673) for hip fractures. Longer length of hospital stay, higher hospital level, and being covered by a health insurance were associated with higher hospitalization costs for all fracture types.

Conclusion

Our study reports hospital costs of the fracture using a large health accounts database in China and investigates the associated factors of hospital costs. Our results may inform cost-of-illness studies and economic evaluations of fracture preventions.
Literature
1.
Townsend Jr, Courtney M et al (2015) Sabiston textbook of surgery E-Book: the biological basis of modern surgical practice. Elsevier Health Sciences
2.
Einhorn TA, Gerstenfeld LC (2015) Fracture healing: mechanisms and interventions. Nat Rev Rheumatol 11(1):45PubMedCrossRef
3.
Donaldson L et al (2008) The epidemiology of fractures in England. J Epidemiol Community Health 62(2):174–180PubMedCrossRef
4.
Si L et al (2015) Residual lifetime and 10 year absolute risks of osteoporotic fractures in Chinese men and women. Curr Med Res Opin 31(6):1149–1156PubMedCrossRef
5.
6.
Mohd-Tahir N, Li S (2017) Economic burden of osteoporosis-related hip fracture in Asia: a systematic review. Osteoporos Int 28(7):2035–2044PubMedCrossRef
7.
8.
9.
Svedbom A et al (2014) Epidemiology and economic burden of osteoporosis in Switzerland. Arch Osteoporos 9(1):187CrossRefPubMed
10.
Treatment, E.B.o.O.P.a, C.H.P. Foundation (2009) White paper on osteoporosis in China. Chin J Health Manag 3(3):148–154
11.
Si L et al (2015) Projection of osteoporosis-related fractures and costs in China: 2010–2050. Osteoporos Int 26(7):1929–1937CrossRefPubMed
12.
Si L et al (2014) A systematic review and meta-analysis of utility-based quality of life for osteoporosis-related conditions. Osteoporos Int 25(8):1987–1997PubMed
13.
James SL et al (2018) Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet 392(10159):1789–1858CrossRef
14.
Kaffashian S et al (2011) The burden of osteoporotic fractures beyond acute care: the Canadian Multicentre Osteoporosis Study (CaMos). Age Ageing 40(5):602–607PubMedCrossRef
15.
Soen S et al (2021) Family caregiver burden of patients with osteoporotic fracture in Japan. J Bone Miner Metab 39(4):612–622
16.
Xiao P, Zhou Y (2020) Factors associated with the burden of family caregivers of elderly patients with femoral neck fracture: a cross-sectional study. J Orthop Surg Res 15(1):234PubMedPubMedCentralCrossRef
17.
Xie Z et al (2015) Posthospital discharge medical care costs and family burden associated with osteoporotic fracture patients in China from 2011 to 2013. J Osteoporos 2015:258089PubMedPubMedCentralCrossRef
18.
Nayak S, Greenspan SL (2017) Osteoporosis treatment efficacy for men: a systematic review and meta-analysis. J Am Geriatr Soc 65(3):490–495PubMedCrossRef
19.
Bartra A et al (2019) Cost of osteoporotic hip fracture in Spain per Autonomous Region. Rev Esp Cir Ortop Traumatol 63(1):56–68
20.
Burgers P et al (2016) Total medical costs of treating femoral neck fracture patients with hemi-or total hip arthroplasty: a cost analysis of a multicenter prospective study. Osteoporos Int 27(6):1999–2008PubMedPubMedCentralCrossRef
21.
Cummings SR, Eastell R (2016) Risk and prevention of fracture in patients with major medical illnesses: a mini-review. J Bone Miner Res 31(12):2069–2072PubMedCrossRef
22.
Lin CW et al (2012) Rehabilitation for ankle fractures in adults. Cochrane Database Syst Rev 11:Cd005595PubMed
23.
Kabboord AD et al (2016) Assessment of comorbidity burden and its association with functional rehabilitation outcome after stroke or hip fracture: a systematic review and meta-analysis. J Am Med Dir Assoc 17(11):1066.e13-1066.e21CrossRef
24.
Bae EY et al (2016) Eight-year experience of using HTA in drug reimbursement: South Korea. Health Policy 120(6):612–620PubMedCrossRef
25.
Zeng F, Wang M, Zhang D (2021) Cost-effectiveness analysis of 5% lidocaine-medicated plaster compared with pregabalin for the treatment of post-herpetic neuralgia in China. Ann Palliat Med 10(4):4493–4501PubMedCrossRef
26.
Mathes T et al (2013) Methods of international health technology assessment agencies for economic evaluations–a comparative analysis. BMC Health Serv Res 13:371PubMedPubMedCentralCrossRef
27.
Li N et al (2021) An updated systematic review of cost-effectiveness analyses of drugs for osteoporosis. Pharmacoeconomics 39(2):181–209
28.
Chen M et al (2019) Epidemiological and clinical study of hip fracture in hospitalized elderly patients in Shanghai, China. Arch Osteoporos 14(1):37PubMedCrossRef
29.
Liu R et al (2018) Incidence and risk factors of medical complications and direct medical costs after osteoporotic fracture among patients in China. Arch Osteoporos 13(1):12PubMedPubMedCentralCrossRef
30.
Wang Y et al (2018) Hospitalisation cost analysis on hip fracture in China: a multicentre study among 73 tertiary hospitals. BMJ Open 8(4):e019147
31.
Yao WJ et al (2001) Differential changes in regional bone mineral density in healthy Chinese: age-related and sex-dependent. Calcif Tissue Int 68(6):330–336PubMedCrossRef
32.
Anagnostis P et al (2019) Association between age at menopause and fracture risk: a systematic review and meta-analysis. Endocrine 63(2):213–224PubMedCrossRef
33.
Gourlay ML et al (2005) Performance of osteoporosis risk assessment tools in postmenopausal women aged 45–64 years. Osteoporos Int 16(8):921–927PubMedCrossRef
34.
Ryu KJ et al (2016) Vasomotor symptoms and osteoporosis in Korean postmenopausal women. Maturitas 87:27–32PubMedCrossRef
35.
36.
Häussler B et al (2007) Epidemiology, treatment and costs of osteoporosis in Germany—the BoneEVA Study. Osteoporos Int 18(1):77–84PubMedCrossRef
37.
Shi N et al (2009) Direct healthcare costs of hip, vertebral, and non-hip, non-vertebral fractures. Bone 45(6):1084–1090PubMedCrossRef
38.
NIH Consens Statement (2000) Osteoporosis prevention, diagnosis, and therapy. NIH Consens Statement 17(1):1–45
39.
Wu J et al (2019) Healthcare resource utilization and direct medical costs for patients with osteoporotic fractures in China. Value Health Reg Issues 18:106–111PubMedCrossRef
40.
Adeyemi A et al (2019) Incidence and economic burden of intertrochanteric fracture: a medicare claims database analysis. JB JS Open Access 4(1):e0045
41.
Pincus D et al (2018) Medical costs of delayed hip fracture surgery. JBJS 100(16):1387–1396CrossRef
42.
Mitchell R et al (2019) Comparison of hospitalised trends, treatment cost and health outcomes of fall-related hip fracture for people aged≥ 65 years living in residential aged care and the community. Osteoporos Int 30(2):311–321PubMedCrossRef
43.
Quevedo I et al (2020) Epidemiology and direct medical cost of osteoporotic hip fracture in Chile. J Osteoporos 2020:5360467
44.
Li J et al (2013) Inpatient hospital costs and length of stay for the treatment of osteoporosis fractures in China. Value Health 16(3):A220–A221CrossRef
45.
Yang Y et al (2013) Outpatient medical costs, indirect costs, and family burden of osteoporosis fracture in China. Value health 16(7):A561CrossRef
46.
Qu B et al (2014) The economic burden of fracture patients with osteoporosis in western China. Osteoporos Int 25(7):1853–1860PubMedCrossRef
47.
Yang Y et al (2015) Inpatient cost of treating osteoporotic fractures in mainland China: a descriptive analysis. Clinicoecon Outcomes Res 7:205–212
48.
Lin X et al (2015) Epidemiology and management of osteoporosis in the People’s Republic of China: current perspectives. Clin Interv Aging 10:1017PubMedPubMedCentral
49.
Center for Health Statistics and Information, National Health and Family Planning Commission (China) (2017) China health and family planning statistics yearbook 2017. National Health and Family Planning Commission (China), Beijing, China
50.
Kanis J et al (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12(5):417–427CrossRefPubMed
51.
52.
Herteleer M et al (2020) Healthcare utilization and related cost of midshaft clavicle fracture treatment in Belgium. Eur J Trauma Emerg Surg 1–7
53.
54.
Einav L, Finkelstein A (2018) Moral hazard in health insurance: what we know and how we know it. Journal of the European Economic Association 16(2)
55.
Zhou Y et al (2020) Medical insurance and healthcare utilization among the middle-aged and elderly in China: evidence from the China health and retirement longitudinal study 2011, 2013 and 2015. BMC Health Serv Res 20(1):654–654PubMedPubMedCentralCrossRef
56.
Wu CH et al (2018) Economic impact and cost-effectiveness of fracture liaison services: a systematic review of the literature. Osteoporos Int 29(6):1227–1242PubMedCrossRef
57.
58.
Katzmarzyk PT, Gledhill N, Shephard RJ (2000) The economic burden of physical inactivity in Canada. CMAJ 163(11):1435–1440PubMedPubMedCentral
59.
China N.H.C.o.t.P.s.R.o (2017) China Health and Family Planning Statistical Yearbook 2017. Peking Union Medical College Press, Beijing
Metadata
Title
Sociodemographic and health system factors associated with variations in hospitalization costs for fractures in adults aged 45 years and over: a cross-sectional study of provincial health accounts in Jiangsu Province, China
Authors
Lizheng Xu
Stephen Jan
Mingsheng Chen
Lei Si
Publication date
01-12-2021
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2021
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-021-01009-1

Other articles of this Issue 1/2021

Archives of Osteoporosis 1/2021 Go to the issue

Original Article

Clinical characteristics and outcomes of patients presenting with hip fractures at a tertiary care hospital in Pakistan

Original Article

Association of calcium intake, lactose intolerance and physical activity with bone health assessed via quantitative ultrasound among young adults of a Malaysian university

Original Article

Association between vitamin D and bone mineral density in Japanese adults: the Unzen study

Original Article

Persistence with oral bisphosphonates and denosumab among older adults in primary care in Ireland

Original Article

Relationship between physical activity, lean body mass, and bone mass in the Mexican adult population

Original Article

The influence of snuff and smoking on bone accretion in late adolescence. The Tromsø study, Fit Futures