Thomson Reuters, Washington DC, USA.
Bone. 2009 Dec;45(6):1084-90. doi: 10.1016/j.bone.2009.07.086. Epub 2009 Aug 5.
Limited data exist regarding the cost of non-hip, non-vertebral (NHNV) fractures. Although NHNV fractures may be less expensive than hip and vertebral fractures, they have a higher incidence rate. The objective of this study was to quantify first-year healthcare costs of hip, vertebral, and NHNV fractures. This was a claims-based retrospective analysis using a case-control design among patients with commercial insurance and Medicare employer-based supplemental coverage. Patients were > or =50 years old with a closed hip, vertebral, or NHNV fracture between 7/1/2001 and 12/31/2004, and continuous enrollment 6 months prior to and 12 months after the index fracture. Adjusted mean first-year healthcare costs associated with these fractures were determined. Six cohorts were identified. Patients 50-64 years: NHNV (n=27,424), vertebral (n=3386) and hip (n=2423); patients > or =65 years: NHNV (n=40,960), vertebral (n=11,751) and hip (n=21,504). The ratio of NHNV to hip fractures was 11:1 in the 50-64 cohort and 2:1 in the > or =65 cohort. Adjusted mean first-year costs associated with hip, vertebral, and NHNV fractures were $26,545, $14,977, and $9183 for the 50-64 age cohort, and $15,196, $6701, and $6106 for patients > or =65 years. After taking prevalence rate into account, the proportion of the total fracture costs accounted for by NHNV, hip, and vertebral fractures were 66%, 21% and 13% for the 50-64 age cohort, and 36%, 52% and 12% for the > or =65 age cohort. Limitations included the exclusion of the uninsured and those covered by Medicaid or military-based insurance programs. The results of this study demonstrate that osteoporotic fractures are associated with significant costs. Although NHNV fractures have a lower per-patient cost than hip or vertebral fractures, their total first-year cost is greater for those 50-64 because of their higher prevalence.
关于非髋部、非脊柱（NHNV）骨折的成本数据有限。尽管 NHNV 骨折的费用可能低于髋部和脊柱骨折，但它们的发病率更高。本研究的目的是量化髋部、脊柱和 NHNV 骨折的第一年医疗保健成本。这是一项基于索赔的回顾性分析，采用病例对照设计，纳入了具有商业保险和联邦医疗保险雇主补充保险的患者。患者年龄≥50 岁，在 2001 年 7 月 1 日至 2004 年 12 月 31 日期间发生闭合性髋部、脊柱或 NHNV 骨折，并且在索引骨折前 6 个月和后 12 个月连续参保。确定了这些骨折相关的第一年医疗保健成本的调整均值。共确定了 6 个队列。50-64 岁患者：NHNV（n=27424）、脊柱（n=3386）和髋部（n=2423）；≥65 岁患者：NHNV（n=40960）、脊柱（n=11751）和髋部（n=21504）。50-64 岁患者中 NHNV 与髋部骨折的比例为 11:1，≥65 岁患者中为 2:1。50-64 岁年龄组中与髋部、脊柱和 NHNV 骨折相关的第一年调整平均成本分别为 26545 美元、14977 美元和 9183 美元，而≥65 岁患者的成本分别为 15196 美元、6701 美元和 6106 美元。考虑到患病率后，NHNV、髋部和脊柱骨折占总骨折成本的比例，50-64 岁年龄组为 66%、21%和 13%，≥65 岁年龄组为 36%、52%和 12%。局限性包括排除了未参保人员以及参加医疗补助或军人保险计划的人员。本研究结果表明，骨质疏松性骨折与重大医疗费用相关。尽管 NHNV 骨折的每位患者成本低于髋部或脊柱骨折，但由于其发病率更高，50-64 岁患者的第一年总成本更高。
