School of Psychology, Deakin University, Burwood, Australia.
Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Australia.
J Bone Miner Res. 2019 Apr;34(4):616-625. doi: 10.1002/jbmr.3640. Epub 2019 Jan 7.
Osteoporosis and osteopenia are increasingly prevalent conditions among older adults. Not only do the fractures associated with poor bone health have significant health consequences for the individual, but also their economic impact is placing increasing financial burden on governments and society. This study aimed to determine the direct economic cost of osteoporosis, osteopenia, and fractures among Australians aged 50 years and older in 2017. This study uses previous Australian data on the incidence and prevalence of osteoporosis and osteopenia together with recent Australian data on health service utilization after fracture to provide an estimate of the economic burden of osteoporosis. A bottom-up costing approach was used to determine the average direct health care and non-health care total costs of a fracture, as well as the average community health service costs of managing individuals with osteoporosis or osteopenia. The total direct cost of osteoporosis in Australia in 2017 was estimated to be $3.44 billion (AUD 2017, USD 2.77 billion). Treatment of fractures accounted for 68% of total direct costs, and non-fracture management of osteoporosis accounted for 32%. Hip fractures accounted for the highest proportion (43%) of the total direct cost of fractures, although fractures at "other" sites accounted for 38.5%. Fractures among individuals aged 70 years and older accounted for 74% of the direct costs (55% and 19% in women and men, respectively). Fracture costs in those with osteopenia accounted for 50% of direct fracture treatment costs. This up-to-date cost analysis estimated that costs in 2017 were three times higher than in 2007. These estimates will aid clinicians, policy makers, researchers, and health care organizations to acknowledge the economic importance of reducing osteoporosis-related fractures and associated costs. This provides a strong public health case to promote bone health that will assist in reducing future fracture-related costs. © 2018 American Society for Bone and Mineral Research.
骨质疏松症和低骨量在老年人中越来越普遍。不仅与骨骼健康不良相关的骨折对个人有重大的健康后果，而且其经济影响也给政府和社会带来了越来越大的经济负担。本研究旨在确定 2017 年澳大利亚 50 岁及以上人群的骨质疏松症、低骨量和骨折的直接经济成本。本研究使用澳大利亚先前关于骨质疏松症和低骨量发病率和患病率的数据，以及最近关于骨折后卫生服务利用的数据，来估计骨质疏松症的经济负担。采用自下而上的成本法来确定骨折的平均直接医疗和非医疗总费用，以及管理骨质疏松症或低骨量个体的社区卫生服务的平均费用。2017 年澳大利亚骨质疏松症的直接总成本估计为 34.4 亿美元（2017 年澳元，27.7 亿美元）。骨折的治疗占直接总成本的 68%，非骨折骨质疏松症管理占 32%。髋部骨折占骨折总直接费用的比例最高（43%），尽管“其他”部位骨折占 38.5%。70 岁及以上人群的骨折占直接费用的 74%（女性和男性分别为 55%和 19%）。低骨量患者的骨折占直接骨折治疗费用的 50%。本最新成本分析估计，2017 年的成本是 2007 年的三倍。这些估计将有助于临床医生、政策制定者、研究人员和卫生保健组织认识到减少与骨质疏松症相关的骨折和相关成本的经济重要性。这为促进骨骼健康提供了有力的公共卫生理由，有助于降低未来与骨折相关的成本。© 2018 美国骨矿研究协会。
