OBJECTIVES: To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. METHODS: From 2002 to 2004, we identified all National Health Insurance claims records for women > or = 50 years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," Ysuch that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with > or = one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. RESULTS: During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. CONCLUSIONS: Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.
*Cost of Illness ; Female ; Financing, Personal ; Humans ; Interviews as Topic ; Korea ; Medical Audit ; Middle Aged ; Osteoporosis/complications/*economics ; Spinal Fractures/economics/etiology/*physiopathology

OBJECTIVETo investigate the net "per case" direct economic burden of osteoporotic hip fracture of in-patients at Peking Union Medical College Hospital (PUMCH), and to explore the related factors which will influence the burden of the disease.

METHODSData was from a retrospective questionnaire on 90 osteoporotic hip fracture in-patients of PUMCH above 50 years old from 1998 to 2002. The direct cost of fracture consisted of inpatient care, outpatient care, home care, appliance, and nutrition etc. Multiple statistics method was used to analyze the factors affecting the direct costs of disease.

RESULTSThe average age of the studied population was 71.78 +/- 9.7 years, including 29 males and 61 females. Yearly direct economic burden for one patient of osteoporotic hip fracture was 32 776 RMB, in which hospitalization expense was 23 107 RMB, accounting for 70.5%. Factors which influencing total direct costs would include: length of hospitalization, occupation and the outcome of disease, while types of hip fracture,occupation and the length of hospitalization affecting the cost during hospitalization. The outcome of disease, length of hospitalization and rehabilitation influenced the cost during convalescence while age, type of payment and treatment, did not show significant influence on the cost of hip fracture.

CONCLUSIONOsteoporosis had become a serious public health problem among the elderly, bringing about the increase of economic burden all over the world both on social healthcare and families of the patients. Our data provided base for preventive health care or health insurance on osteoporosis.

Adult ; Age of Onset ; Aged ; Analysis of Variance ; Cost of Illness ; Female ; Health Knowledge, Attitudes, Practice ; Hip Fractures ; complications ; diagnosis ; economics ; therapy ; Hospitalization ; economics ; Humans ; Logistic Models ; Male ; Middle Aged ; Osteoporosis ; complications ; diagnosis ; economics ; therapy ; Prognosis ; Retrospective Studies

INTRODUCTIONWe evaluated if there was significant stress in caregivers of elderly patients with osteoporotic hip fractures and determine any contributory factors.

MATERIALS AND METHODSA prospective cohort study was performed from June 2005 to June 2006 in a single tertiary hospital. Patients admitted during this period and their primary caregivers were interviewed on admission and at 6 months. Information on patient's demographics, comorbidities, functional and mental status, placement post-discharge and financial strain were noted. Caregiver stress was measured using the caregiver strain index (CSI). Relationships between key variables were analysed to derive possible correlations.

RESULTSThe study comprised caregivers of 76 patients with a mean age of 77 years (range, 50 to 95; SD, 11). Within 1 week of admission, 45 of the 76 caregivers (59.2%) were significantly stressed based on the CSI while at 6 months, 30 of the caregivers (50%) were significantly stressed. The mean CSI within 1 week of admission and at 6 months post-admission was 7.18 and 6.25 respectively (P = 0.042). The most significant contributory factor to stress was financial strain (P = 0.01) attributable to medical bills, rehabilitation costs and transport expenses.

CONCLUSIONThere is a significant amount of stress that is experienced by caregivers of elderly patients with hip fractures which commences from admission of the patient and it remains high at 6-months post-fracture. Financial strain has been found to be the only significant cause on both univariate and multivariate analysis. Adequate resources should be available to caregivers of patients with osteoporotic hip fractures.

Aged ; Aged, 80 and over ; Caregivers ; economics ; psychology ; Cost of Illness ; Female ; Hip Fractures ; etiology ; rehabilitation ; Humans ; Male ; Middle Aged ; Osteoporosis ; complications ; Prospective Studies ; Stress, Psychological