Levy P, Levy E, Audran M, Cohen-Solal M, Fardellone P, Le Parc J M
LEGOS, Paris-Dauphine University, France.
Bone. 2002 Apr;30(4):631-6. doi: 10.1016/s8756-3282(01)00708-6.
The objective of this study was to estimate the annual direct medical costs of osteoporosis and osteoporotic fractures incurred by French men > or =50 years of age. Costs were assessed from a societal perspective for 1999 and expressed in Euros. An expert panel was consulted to identify fractures attributable to osteoporosis according to International Classification of Diseases (ICD)-10 codes. Available age- and gender-specific osteoporosis attribution probabilities (OAP) were used to derive the proportion of health-care utilization for fractures resulting from osteoporosis. Hospital and ambulatory care costs due to fractures were obtained from French databases. A total of 23,260 acute hospitalizations were found to be caused by osteoporosis, 52% of which are for hip fractures. Mean cost per stay varied widely according to the site of fracture, from 1300 (wrist fracture) to 5900 (hip fracture). Consequently, the total cost of acute hospitalization amounts to 97.6 million, with hip fractures accounting for 73.2% of the expenditures. Rehabilitation and convalescence costs were estimated to be 90.8 million, generating a total hospital cost of 188.4 million. The total outpatient costs were estimated to be 9.1 million. Thus, the total medical costs of male osteoporosis amount to 197.5 million. A sensitivity analysis was performed to test the robustness of this figure. We estimate the number of fractures by applying international incidence rates from the literature to the French male population aged > or =50 years, whereas the OAP and unit costs were kept constant. This approach yielded an estimate of 21,857 fractures, which is only 6% below the base case. When compared with values from other countries, our study results appear very conservative.
本研究的目的是估算年龄≥50岁的法国男性骨质疏松症及骨质疏松性骨折的年度直接医疗费用。从社会角度评估了1999年的费用，并以欧元表示。咨询了一个专家小组，根据国际疾病分类（ICD）-10编码确定可归因于骨质疏松症的骨折。利用现有的年龄和性别特异性骨质疏松症归因概率（OAP）来推算因骨质疏松症导致的骨折的医疗保健利用率。骨折导致的住院和门诊护理费用来自法国数据库。共发现23260例急性住院是由骨质疏松症引起的，其中52%是髋部骨折。每次住院的平均费用因骨折部位而异，从1300欧元（腕部骨折）到5900欧元（髋部骨折）不等。因此，急性住院的总费用达9760万欧元，其中髋部骨折占支出的73.2%。康复和疗养费用估计为9080万欧元，住院总费用为1.884亿欧元。门诊总费用估计为910万欧元。因此，男性骨质疏松症的总医疗费用达1.975亿欧元。进行了敏感性分析以检验该数字的稳健性。我们通过将文献中的国际发病率应用于年龄≥50岁的法国男性人口来估算骨折数量，而OAP和单位成本保持不变。这种方法得出骨折数量估计为21857例，仅比基础情况低6%。与其他国家的值相比，我们的研究结果显得非常保守。
