Analysis Group, Inc., 111 Huntington Avenue, 10th Floor, Boston, MA 02199, USA.
Osteoporos Int. 2011 Jan;22(1):47-56. doi: 10.1007/s00198-010-1267-5. Epub 2010 May 20.
This study assesses the costs of non-vertebral osteoporosis-related fractures patients compared with osteoporosis patients without fractures, focusing on the second year following a fracture. Since fracture patients remained more costly in the second year, their economic burden extends beyond the year in which the fracture occurs.
The purpose of this study is to examine the comorbidity profile, resource use, and direct costs of patients who incur osteoporosis-related non-vertebral (NV) fractures in the United States during the 2 years following an incident fracture, focusing on the second year following a fracture.
Osteoporosis patients (ICD-9-CM: 733.0) with a NV fracture (hip, femur, pelvis, lower leg, upper arm, forearm, rib, and multiple sites) were selected from a privately insured health insurance claims database (>8 million lives, ages 18-64, 1999-2006). These NV fracture patients were randomly matched 1:1 on age, gender, employment status, and geographic region to controls with osteoporosis but without a fracture history. Year-by-year and month-by-month rates of comorbidities, resource use, and direct costs were calculated for the matched sample (N = 3,781).
Comorbidity rates and resource use remained significantly higher among NV fracture patients during second year following an NV fracture compared with controls, although absolute rates of comorbidities and service utilization declined. Mean direct excess costs for NV fracture patients fell from $5,267 in the first year to $2,072 in the second year after a fracture, but remained statistically significant (p < 0.01). Patients with fractures of the pelvis, hip, and femur had the highest excess costs in the second year ($5,121, $3,930, and $3,828, respectively). Although hip fractures had highest excess costs over both years, non-vertebral, non-hip fracture patients made up a larger proportion of the sample and were significantly more costly than controls.
Patients with osteoporosis-related NV fractures have substantial excess costs beyond the first year in which the fracture occurs.
本研究评估了与骨质疏松症相关的非椎体骨折患者与无骨折的骨质疏松症患者的成本，重点关注骨折后第二年的情况。由于骨折患者在第二年的花费仍然更高，因此他们的经济负担超出了骨折发生的那一年。
从私人保险健康保险索赔数据库（800 多万份保单，年龄 18-64 岁，1999-2006 年）中选择患有骨质疏松症且伴有非椎体（髋部、股骨、骨盆、小腿、上臂、前臂、肋骨和多处部位）骨折的骨质疏松症患者（ICD-9-CM：733.0）。这些非椎体骨折患者按年龄、性别、就业状况和地理位置与无骨折史的骨质疏松症对照患者进行 1:1 随机匹配。对匹配样本（N=3781）逐年逐月计算合并症、资源使用和直接成本的发生率。
与对照组相比，非椎体骨折患者在骨折后第二年的合并症发生率和资源使用率仍然显著较高，尽管合并症的绝对发生率和服务利用率有所下降。非椎体骨折患者的直接超额费用从骨折后第一年的 5267 美元降至第二年的 2072 美元，但仍具有统计学意义（p<0.01）。骨盆、髋部和股骨骨折患者在第二年的超额费用最高（分别为 5121 美元、3930 美元和 3828 美元）。尽管髋部骨折在两年内的超额费用最高，但非椎体、非髋部骨折患者在样本中所占比例更大，且比对照组显著更昂贵。
与骨质疏松症相关的非椎体骨折患者在骨折发生后的第一年之后仍有大量的超额费用。
