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了解偶发性骨质疏松性骨折对韩国绝经后女性医疗保健利用和成本的长期影响。

Understanding the long-term impact of incident osteoporotic fractures on healthcare utilization and costs in Korean postmenopausal women.

机构信息

Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA.

College of Pharmacy, Woosuk University, Wanju-gun, Jeollabuk-do, South Korea.

出版信息

Osteoporos Int. 2024 Feb;35(2):339-352. doi: 10.1007/s00198-023-06934-0. Epub 2023 Oct 25.

Abstract

UNLABELLED

This study provides long-term evidence that healthcare resource utilization and costs of care in women who experienced incident osteoporotic fractures remained higher than those in women without fractures over a span of 5 years. These findings emphasize the importance of early diagnostics and treatment for osteoporosis.

PURPOSE

To evaluate healthcare resource utilization (HCRU) and costs of care over 5 years after the incident osteoporotic fractures (OF) in postmenopausal women.

METHODS

We used data from the National Health Insurance Service databases 2011-2018. Women aged ≥ 50 years with incident OF (OF group) were matched to women without OF (non-OF group). HCRU (inpatient, outpatient, and emergency room [ER] visits) and costs of care (inpatient, outpatient, and ER visits) during the 5-year follow-up period were derived after propensity score matching (PSM). Additionally, we identified women with subsequent fractures within the first 2 years after the incident OF.

RESULTS

After PSM, 47,238 OF and 134,813 non-OF women were identified. HCRU rates and costs of care were highest in the first year after OF and decreased substantially, but remained higher in the OF group during the entire follow-up period. The increase in cumulative HCRU rates over 5 years was highest in inpatient admissions with ER visits (138% higher in OF vs non-OF). The cumulative total costs over 5 years were 73% higher in the OF group than in the non-OF group, which was mostly driven by inpatient costs. Trends were similar for women with subsequent fractures, but they generally showed higher HCRU and costs than those in the total OF group.

CONCLUSION

OF imposes a substantial and sustained economic burden on women, resulting in an approximately twofold increase in the cumulative cost over 5 years compared to women without fracture, which highlights the need for early diagnostics and treatment of osteoporosis.

摘要

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本研究提供了长期证据,表明在经历骨质疏松性骨折的女性中,医疗资源利用和护理成本在 5 年内仍高于无骨折的女性。这些发现强调了早期诊断和骨质疏松症治疗的重要性。

目的

评估绝经后女性经历骨质疏松性骨折(OF)后 5 年内的医疗资源利用(HCRU)和护理成本。

方法

我们使用了 2011-2018 年国家健康保险服务数据库的数据。≥50 岁的患有骨质疏松性骨折(OF)的女性(OF 组)与没有 OF 的女性(非 OF 组)相匹配。在倾向评分匹配(PSM)后,得出了 5 年随访期间的 HCRU(住院、门诊和急诊就诊)和护理成本(住院、门诊和急诊就诊)。此外,我们还确定了在首次发生 OF 后 2 年内发生后续骨折的女性。

结果

PSM 后,共确定了 47238 例 OF 和 134813 例非 OF 女性。OF 发生后第一年 HCRU 率和护理成本最高,随后大幅下降,但在整个随访期间 OF 组仍较高。5 年内累积 HCRU 率增加最高的是急诊住院(OF 比非 OF 高 138%)。OF 组 5 年内累计总成本比非 OF 组高 73%,这主要是由住院费用驱动的。对于有后续骨折的女性,趋势相似,但它们通常表现出比总 OF 组更高的 HCRU 和成本。

结论

OF 给女性带来了巨大且持续的经济负担,导致 5 年内累积成本比无骨折的女性增加约两倍,这突出表明需要早期诊断和治疗骨质疏松症。

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