Lange A, Zeidler J, Braun S
Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Koenigsworther Platz 1, 30167, Hannover, Germany,
Osteoporos Int. 2014 Oct;25(10):2435-43. doi: 10.1007/s00198-014-2776-4. Epub 2014 Jul 8.
The study aims to estimate the direct disease-related costs of osteoporotic vertebral compression fractures (OVCF) in patients with newly diagnosed fracture in the first year after index in Germany. Analyses reveal that OVCFs are associated with significant costs. In light of high and increasing incidence, the results emphasize importance of research in this field.
OVCF are among the most common fractures related to osteoporosis. They have been shown to be associated with excess mortality and meaningful healthcare costs. Costs calculations have illustrated the significant financial burden to society and national social security systems. However, this information is not available for Germany. Therefore, aim of the study was to estimate the direct disease-related costs of OVCF in patients with newly diagnosed fracture in the first year after index in Germany.
Data were obtained from a claims dataset of a large German health insurance fund. Subjects ≥ 60 years with a new vertebral fracture between 2006 and 2010 were studied retrospectively compared to a matched paired OVCF-free patient group. All-cause and fracture-specific medical costs were calculated in the 1-year baseline and follow-up period. Generalized linear model (GLM) was estimated for total follow-up healthcare cost.
A total of 2,277 pairs of matched OVCF and OVCF-free patients were included in the analysis. Baseline costs were higher in the OVCF group. Mean unadjusted all-cause healthcare cost difference in the four quarters following the index date between OVCF and OVCF-free patients was 8,200
Despite limitations of this study, our results are consistent with other research and demonstrate that OVCFs are associated with significant costs. The results underline the importance of medical interventions that can help to prevent fractures and treatments, which are cost-effective and can prevent recurrent fractures.
本研究旨在估算德国初次发病后第一年新诊断骨折患者骨质疏松性椎体压缩骨折（OVCF）与疾病直接相关的成本。分析表明，OVCF会带来巨大成本。鉴于其发病率居高不下且不断上升，研究结果凸显了该领域研究的重要性。
OVCF是与骨质疏松症相关的最常见骨折类型之一。研究表明，它们与额外死亡率和可观的医疗成本相关。成本计算显示，这给社会和国家社会保障系统带来了巨大的经济负担。然而，德国尚无此类信息。因此，本研究的目的是估算德国初次发病后第一年新诊断骨折患者OVCF与疾病直接相关的成本。
数据取自德国一家大型健康保险基金的理赔数据集。对2006年至2010年间年龄≥60岁且有新椎体骨折的受试者进行回顾性研究，并与配对的无OVCF患者组进行比较。在1年基线期和随访期计算全因及骨折特异性医疗成本。采用广义线性模型（GLM）估算随访期总医疗成本。
分析共纳入2277对匹配的OVCF患者和无OVCF患者。OVCF组的基线成本更高。初次发病日期后的四个季度中，OVCF患者与无OVCF患者未经调整的平均全因医疗成本差异为8200欧元（p < 0.001）。其中，近三分之二归因于住院服务，四分之一归因于处方药成本。GLM程序显示，初次发病日期后第一年与OVCF相关的成本总计6490欧元（p < 0.001；置信区间5809欧元 - 6731欧元）。
尽管本研究存在局限性，但我们的结果与其他研究一致，表明OVCF会带来巨大成本。研究结果强调了有助于预防骨折的医疗干预措施以及具有成本效益且能预防骨折复发的治疗方法的重要性。
