Wu Jing, Qu Yi, Wang Ke, Chen Yu
School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China.
School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China.
Value Health Reg Issues. 2019 May;18:106-111. doi: 10.1016/j.vhri.2018.11.008. Epub 2019 Mar 23.
To estimate annual healthcare resource utilization and direct medical costs for patients with osteoporotic fractures in China.
Data were obtained from the Tianjin Urban Employee Basic Medical Insurance database (2008-2011). Included patients were 50 years or older with one or more diagnoses of osteoporotic fractures between 2009 and 2010. The annual healthcare resource utilization and direct medical costs were estimated. Regression model was applied to identify factors associated with the direct medical costs.
A total of 5941 patients were included (mean age, 65.9 years; women, 62.1%; retired, 88.2%). During the 12 months after a fracture, the annual mean all-cause cost was $2549 per patient. Osteoporosis-related costs accounted for 53.8% of the total costs; 92.0% of these costs were for inpatient services. For osteoporosis-related health services, 33.2% of the patients experienced at least 1 hospitalization, with a mean cost of $3010 per admission; 83.2% of the patients experienced at least 1 outpatient visit, with a mean cost of $18 per visit during the 12-month follow-up period. The regression model revealed that osteoporosis-related costs tended to increase with age, and patients with hip, vertebral, lower leg, and multiple fractures were more likely to have higher costs.
Costs for patients with osteoporotic fractures were considerable in China, driven mainly by osteoporosis-related hospitalizations. Efforts focused on reducing the utilization of inpatient services by lowering the fracture risks may lighten the economic burden of osteoporotic fractures in China.
估算中国骨质疏松性骨折患者的年度医疗资源利用率及直接医疗费用。
数据来源于天津市城镇职工基本医疗保险数据库(2008 - 2011年)。纳入的患者年龄在50岁及以上,在2009年至2010年间有一项或多项骨质疏松性骨折诊断。估算年度医疗资源利用率及直接医疗费用。应用回归模型确定与直接医疗费用相关的因素。
共纳入5941例患者(平均年龄65.9岁;女性占62.1%;退休人员占88.2%)。骨折后的12个月内,每位患者的年度平均全因费用为2549美元。骨质疏松相关费用占总费用的53.8%;其中92.0%用于住院服务。对于骨质疏松相关的医疗服务,33.2%的患者至少经历过1次住院治疗,每次住院的平均费用为3010美元;83.2%的患者至少经历过1次门诊就诊,在12个月的随访期内每次就诊的平均费用为18美元。回归模型显示,骨质疏松相关费用往往随年龄增长而增加,髋部、脊椎、小腿和多处骨折的患者费用更高的可能性更大。
中国骨质疏松性骨折患者的费用相当可观,主要由骨质疏松相关的住院治疗所致。通过降低骨折风险来减少住院服务利用率的努力可能会减轻中国骨质疏松性骨折的经济负担。