Medical costs of osteoporosis

• Published in: Bone (New York, N.Y.) Vol. 13; pp. S11 - S16
• Main Author: Norris, R.J.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 1992; Elsevier Science
• Subjects: Age Factors; Biological and medical sciences; Cost; Cost-Benefit Analysis; Diseases of the osteoarticular system; Female; Hip Fractures - economics; Hospitalization - economics; Hospitalization - statistics & numerical data; Humans; Male; Medical sciences; Osteoporosis; Osteoporosis - economics; Osteoporosis. Osteomalacia. Paget disease; Quality of Life; Spinal Fractures - economics; United States; United States; Osteoporosis; Cost; Quality of life; Human; Health economy; Diseases of the osteoarticular system; Bone disease; Cost analysis; Public health
• ISSN: 8756-3282; 1873-2763
• DOI: 10.1016/8756-3282(92)90190-8

Global healthcare expenditure has risen at an alarming rate over the past thirty years and the situation is most pronounced in the USA, which now spends 12% of its gross domestic product on healthcare. The greatest component of this expenditure is accounted for by the costs of hospitalisation, and is also particularly centred on the elderly sector of the population — a group that, relative to other sections of the population, will expand over the next thirty years. Osteoporosis, a chronic, disabling disorder, predominantly affects the elderly. Growth in the recognition and level of intervention in osteoporosis, when viewed alongside the increase in the elderly population, emphasises the need to examine the costs of osteoporosis against the already burgeoning healthcare bill. A detailed study in the USA in 1986 assessed the direct medical costs of osteoporosis in women over the age of 45: analysis included the costs of hospitalisation, nursing home care and outpatient services. The results of this survey revealed a figure for total direct costs of $5.15 billion, with hospital and nursing home care being the greatest contributors. A subsequent analysis of data for 1989 has shown expenditure to have risen to over $6 billion. This form of economic assessment of direct medical costs, based on discharge surveys and audit data, is likely to be reasonably accurate for osteoporosis-related hip and wrist fractures, which will generally present to hospitals, but less so for vertebral fractures, which have a varied clinical presentation. Quality of life, disability, socioeconomic factors — also costs to patients, relatives, or healthcare providers — are not accounted for by pure economic analyses of the direct medical burden. A pilot study performed in 1986 showed that osteoporotic patients had a reduced quality of life compared with age-matched controls, which progressively decreased with increasing severity of fracture. In addition to the large and escalating direct costs, osteoporosis needs to be more thoroughly investigated in respect of the total impact on patients, the socioeconomic burden and the utility value of therapeutic interventions.