NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University of Lisbon, Lisbon, Portugal.
EpiDoC Unit, CEDOC, NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal.
Osteoporos Int. 2023 Dec;34(12):2111-2119. doi: 10.1007/s00198-023-06881-w. Epub 2023 Aug 19.
Osteoporosis-related fractures lead to high morbidity, mortality, and healthcare costs among post-menopausal women. This study showed that incident non-hip osteoporosis-related fractures are frequent among women aged 50 + in Portugal, leading to excessive healthcare costs of €74 million per year, in a conservative scenario.
This study aimed to estimate the costs of incident non-hip osteoporosis-related fractures among postmenopausal women living in Portugal from a payer perspective.
The study includes women ≥ 50 years old who participated in the baseline assessment (2011-2013) and the first follow-up wave (2013-2015) of the Epidemiology of Chronic Diseases cohort, a Portuguese community-based longitudinal prospective study (n = 2,762). Incident non-hip osteoporosis-related fractures were defined as any self-reported low impact non-hip fractures since baseline. Healthcare resource utilization during the year following fracture was obtained from an informal panel of experts. The amounts of resources used were multiplied by the national tariffs practiced in the National Health Service (NHS) to obtain the cost per patient in the year following a wrist, vertebral, or other site fracture, which was subsequently multiplied by the estimated annual number of incident fractures to obtain the total annual cost of incident non-hip osteoporosis-related fractures among postmenopausal women.
Each year approximately 5,000 wrist, 3,500 vertebral, and 39,000 other-site osteoporosis-related fractures occur in women aged 50 + in Portugal. Healthcare costs per patient in the year following fracture vary from €2,709.52 for vertebral fractures to €3,096.35 for other fractures. Non-hip incident osteoporosis-related fractures among 50 + women cost approximately €74 million per year. Among all healthcare services, physiotherapy represents the bulk of costs.
This study pinpoints the relevance of preventing non-hip osteoporosis-related fractures, as these cost about €74 million per year in direct healthcare costs, a substantial impact on the budget of the Portuguese NHS.
本研究旨在从支付者角度估计葡萄牙绝经后妇女发生非髋部骨质疏松性骨折的成本。
本研究纳入了参加葡萄牙基于社区的纵向前瞻性研究（Epidemiology of Chronic Diseases 队列）基线评估（2011-2013 年）和第一次随访（2013-2015 年）的≥50 岁女性（n=2762）。非髋部骨质疏松性骨折是指自基线以来任何报告的低影响非髋部骨折。骨折后一年内的医疗资源利用情况从一个非正式的专家小组获得。使用的资源数量乘以国家卫生服务（NHS）实行的国家关税，以获得腕部、椎体或其他部位骨折后患者每年的成本，随后乘以估计的每年新发骨折数量，以获得绝经后妇女非髋部骨质疏松性骨折的总年度成本。
葡萄牙每年约有 5000 例腕部、3500 例椎体和 39000 例其他部位骨质疏松性骨折发生在 50 岁以上的女性中。骨折后一年每位患者的医疗保健费用从椎体骨折的€2709.52 到其他骨折的€3096.35 不等。50 岁以上女性非髋部新发骨质疏松性骨折每年花费约€7400 万。在所有医疗服务中，物理治疗占成本的大部分。
本研究指出预防非髋部骨质疏松性骨折的重要性，因为这些骨折直接医疗成本每年约为€7400 万，对葡萄牙 NHS 的预算有重大影响。
