Economics and Analysis Unit, Strategic Reform and Planning Branch, NSW Ministry of Health, St Leonards, New South Wales, Australia.
Institute for Evidence Based Healthcare, Faculty of Health Science and Medicine, Bond University, Robina, QLD, Australia.
Arch Osteoporos. 2022 May 6;17(1):76. doi: 10.1007/s11657-022-01105-w.
This detailed 11-year longitudinal analysis calculated the public health cost of managing refractures in people aged ≥ 50 years in Australia's most populous state. It provides current and projected statewide health system costs associated with managing osteoporosis and provides a foundation to evaluate a novel statewide model of fracture prevention.
The purpose of this longitudinal analysis was to calculate current and projected refracture rates and associated public hospital utilisation and costs in New South Wales (NSW), Australia. These results will be used to inform scaled implementation and evaluation of a statewide Osteoporotic Refracture Prevention (ORP) model of care.
Linked administrative data (inpatient admissions, outpatient attendances, Emergency Department presentations, deaths, cost) were used to calculate annual refracture rates and refracture-related service utilisation between 2007 and 2018 and healthcare costs between 2008 and 2019. Projections for the next decade were made using 'business-as-usual' modelling.
Between 2007 and 2018, 388,743 people aged ≥ 50 years experienced an index fracture and 81,601 had a refracture. Refracture was more common in older people (rising from a cumulative refracture rate at 5 years of 14% in those aged 50-64 years, to 44% in those aged > 90 years), women with a major index fracture (5-year cumulative refracture rate of 26% in females, compared to 19% for males) or minimal trauma index fracture and those with an osteoporosis diagnosis (5-year cumulative refracture rate of 36% and 22%, respectively in those with and without an osteoporosis diagnosis). Refractures increased from 8774 in 2008 to 14,323 in 2018. The annual cost of refracture to NSW Health increased from AU$130 million in 2009 to AU$194 million in 2019. It is projected that, over the next decade, if nothing changes, 292,537 refracture-related hospital admissions and Emergency Department presentations and 570,000 outpatient attendances will occur, at an estimated total cost to NSW Health of AU$2.4 billion.
This analysis provides a detailed picture of refractures and associated projected service utilisation and costs over the next decade in Australia's most populous state. Understanding the burden of refracture provides a foundation for evaluation of a novel statewide ORP model of care to prevent refractures in people aged ≥ 50 years.
本详尽的 11 年纵向分析计算了澳大利亚人口最多的州 50 岁及以上人群中治疗再骨折的公共卫生成本。它提供了与骨质疏松症管理相关的当前和预计全州卫生系统成本，并为评估全州骨质疏松性骨折预防（ORP）新模式提供了基础。
本纵向分析旨在计算澳大利亚新南威尔士州（新州）当前和预计的再骨折率以及相关的公立医院利用情况和成本。这些结果将用于为全州骨质疏松性骨折预防（ORP）模式的实施和评估提供信息。
使用链接的行政数据（住院、门诊就诊、急诊就诊、死亡、成本）计算了 2007 年至 2018 年期间的年度再骨折率和再骨折相关服务利用情况，以及 2008 年至 2019 年期间的医疗保健成本。使用“按现状”建模对未来十年进行了预测。
在 2007 年至 2018 年间，388743 名 50 岁及以上的人经历了一次索引性骨折，81601 人发生了再骨折。再骨折在老年人中更为常见（5 年累积再骨折率从 50-64 岁人群的 14%上升到 90 岁以上人群的 44%）、女性中主要索引性骨折（女性 5 年累积再骨折率为 26%，男性为 19%）或轻微创伤索引性骨折，以及诊断为骨质疏松症的患者（5 年累积再骨折率分别为 36%和 22%，在有和没有骨质疏松症诊断的患者中）。再骨折从 2008 年的 8774 例增加到 2018 年的 14323 例。新南威尔士州卫生部门的再骨折年度成本从 2009 年的 1.3 亿澳元增加到 2019 年的 1.94 亿澳元。预计在未来十年内，如果不采取任何措施，将有 292537 例与再骨折相关的住院和急诊就诊，以及 570000 例门诊就诊，新南威尔士州卫生部门的总成本预计为 24 亿澳元。
本分析提供了澳大利亚人口最多的州未来十年内再骨折及相关预计服务利用情况和成本的详细情况。了解再骨折的负担为评估全州骨质疏松性骨折预防新模式提供了基础，该模式旨在预防 50 岁及以上人群的再骨折。
