Tucci Joseph R
Division of Endocrinology, Roger Williams Medical Center, Providence, RI, USA.
Am J Manag Care. 2006 May;12(7 Suppl):S181-90.
Osteoporosis affects about 10 million individuals in the United States, a number that is expected to increase substantially in coming decades as the elderly population burgeons. The chief debilitating consequence of osteoporosis, fracture, will affect about half the women and a third of the men in their lifetime, posing a daunting challenge to managed healthcare systems in terms of delivering optimal care and restraining cost. By encouraging optimal postfracture follow-up care and identifying those members at higher risk for fracture and in need of prompt treatment, managed care organizations can enhance the cost-effective management of osteoporosis, dampening downstream costs. This manuscript reviews the pathophysiology of osteoporosis, examines issues related to the diagnosis of osteoporosis, especially the role of bone mineral density measurement, and focuses on the impact of various treatment options in reducing fracture risk. Early assessment and treatment emerge as medically prudent steps in reducing the risk for osteoporosis-related fracture.
在美国，约有1000万人患有骨质疏松症。随着老年人口的迅速增长，预计在未来几十年里这一数字将大幅增加。骨质疏松症的主要致残后果是骨折，一生中约有一半的女性和三分之一的男性会受到影响，这对管理式医疗系统在提供最佳护理和控制成本方面构成了严峻挑战。通过鼓励骨折后进行最佳的后续护理，并识别出那些骨折风险较高且需要及时治疗的成员，管理式医疗组织可以提高骨质疏松症的成本效益管理，降低下游成本。本文回顾了骨质疏松症的病理生理学，探讨了与骨质疏松症诊断相关的问题，特别是骨密度测量的作用，并重点关注了各种治疗方案在降低骨折风险方面的影响。早期评估和治疗是降低骨质疏松症相关骨折风险的明智医疗措施。
