Department of Medicine, Holbæk Hospital, Smedelundsgade 60, DK-4300 Holbæk, Denmark; OPEN - Open Patient data Explorative Network, Department of Clinical Research, University of Southern Denmark and Odense University Hospital, J. B. Winsløws Vej 9A, 3rd floor, DK-5000 Odense C, Denmark.
UCB Pharma, Allée de la Recherche 60, 1070 Brussels, Belgium; Medical Image Computing, ESAT-PSI, Department of Electrical Engineering, KU Leuven, Kasteelpark Arenberg 10, Box 2441, 3001 Leuven, Belgium.
Bone. 2023 Oct;175:116831. doi: 10.1016/j.bone.2023.116831. Epub 2023 Jun 22.
Vertebral fractures (VFs) are often available on radiological imaging undertaken during daily clinical work, yet the healthcare cost burden of these opportunistically identifiable fractures has not previously been reported. In this study, we examine the direct healthcare costs of subjects with vertebral fractures available for identification on routine CT scans.
Thoracolumbar vertebral fractures were identified from 2000 routine CT scans. Subjects with VF on the scan were matched 1:2 against subjects with no VF on the scan, and similarly in a 1:3-ratio against a general population cohort. We excluded those subjects who received treatment with osteoporosis medication(s) in the year prior to baseline. Direct healthcare costs, identified from the national Danish registers, were accrued over up to 6 years of follow-up, and reported per day at risk and per year.
In subjects undergoing a CT scan, costs were initially high, yet declined over time. Comparing subjects with prevalent vertebral fracture (n = 321) against those subjects with no vertebral fracture (n = 606), mean total healthcare costs per day at risk was numerically higher in the first three years after baseline, while healthcare costs per year were similar between the cohorts. No differences reached statistical significance. When compared to the general population cohort, costs were significantly higher in the vertebral fracture cohort.
Subjects with vertebral fractures available for identification on routine CT scans incur substantially higher healthcare costs than matched subjects representing the general population, and numerically, albeit non-significantly, higher healthcare costs per day at risk in the short term, as compared to subjects with no visible VF on the CT scan.
椎体骨折（VF）通常可在日常临床工作中进行的放射影像学检查中发现，但这些偶发性可识别骨折的医疗保健成本负担此前尚未报道。在这项研究中，我们检查了在常规 CT 扫描中可识别的椎体骨折患者的直接医疗保健成本。
从 2000 例常规 CT 扫描中确定胸腰椎椎体骨折。在扫描中存在 VF 的患者与扫描中不存在 VF 的患者按 1:2 进行匹配，与一般人群队列按 1:3-3 进行匹配。我们排除了在基线前一年接受骨质疏松症药物治疗的患者。直接医疗保健成本从丹麦国家登记册中确定，在长达 6 年的随访中累积，并按风险日和年报告。
在接受 CT 扫描的患者中，成本最初较高，但随着时间的推移而下降。与存在椎体骨折的患者（n=321）相比，与没有椎体骨折的患者（n=606）相比，在基线后前三年，风险日的平均总医疗保健成本在数值上更高，而两组的年度医疗保健成本相似。差异无统计学意义。与一般人群队列相比，骨折队列的成本明显更高。
在常规 CT 扫描中可识别的椎体骨折患者的医疗保健成本明显高于匹配的代表一般人群的患者，并且与 CT 扫描中无可见 VF 的患者相比，在短期内风险日的医疗保健成本在数值上（尽管无统计学意义）更高。
