Borgström Fredrik, Sobocki Patrik, Ström Oskar, Jönsson Bengt
European Health Economics, Stockholm, Sweden.
Bone. 2007 Jun;40(6):1602-9. doi: 10.1016/j.bone.2007.02.027. Epub 2007 Mar 7.
In osteoporosis, the bone mass is decreased, thereby increasing the risk of fractures. Common osteoporotic fractures include those at the hip, the spine and the forearm. Fractures are a burden to society; in terms of costs, morbidity and mortality. The main objective of this study was to estimate the burden of osteoporosis in Sweden. The study used a prevalence-based bottom-up approach to estimate the total annual burden of osteoporosis in Sweden. The burden was assessed from a societal perspective including medical care costs, non-medical care costs, informal care and indirect costs. Moreover, the value of quality-adjusted life-years (QALYs) lost because of fractures was included in the total burden estimations. The total annual fracture cost was estimated at MSEK 5639, which is about 3.2% of the total health care costs in Sweden. Community care was the most important cost category accounting for 66% of the total annual cost followed by medical care costs (31%), informal care (2%) and indirect costs (1%). By combining the annual value of QALYs lost (MSEK 10354) and the annual fracture costs, the total annual societal burden of osteoporosis in Sweden was estimated at MSEK 15183. Assuming no changes in the age-differentiated fracture risk, the annual burden of osteoporosis was projected to increase to MSEK 26301 in the year 2050. The present study shows the societal burden of osteoporosis in Sweden to be higher than previously perceived. This burden is substantial and must be acknowledged as an important health problem. Osteoporosis-related fractures do not only lead to high medical care costs but also to high community care costs.
在骨质疏松症中,骨量减少,从而增加了骨折风险。常见的骨质疏松性骨折包括髋部、脊柱和前臂骨折。骨折给社会带来负担,包括成本、发病率和死亡率方面。本研究的主要目的是估计瑞典骨质疏松症的负担。该研究采用基于患病率的自下而上方法来估计瑞典骨质疏松症的年度总负担。从社会角度评估负担,包括医疗保健成本、非医疗保健成本、非正式护理和间接成本。此外,因骨折而损失的质量调整生命年(QALY)的价值也纳入了总负担估计中。年度骨折总成本估计为56.39亿瑞典克朗,约占瑞典医疗保健总费用的3.2%。社区护理是最重要的成本类别,占年度总成本的66%,其次是医疗保健成本(31%)、非正式护理(2%)和间接成本(1%)。通过将损失的QALY年度价值(103.54亿瑞典克朗)与年度骨折成本相结合,瑞典骨质疏松症的年度社会总负担估计为151.83亿瑞典克朗。假设年龄差异化骨折风险不变,预计到2050年骨质疏松症的年度负担将增至263.01亿瑞典克朗。本研究表明,瑞典骨质疏松症的社会负担高于先前的认知。这一负担相当大,必须被视为一个重要的健康问题。与骨质疏松症相关的骨折不仅导致高昂的医疗保健成本,还导致高昂的社区护理成本。