Purpose: Osteoporosis is a prevalent disease, characterized by low bone mass and increased fracture risk. One of the major costs of osteoporosis is the need for acute care hospitalizations related to fractures. The purpose is to estimate the current economic burden of acute care hospitalizations for osteoporosis and fractures related to osteoporosis in Canada.
Method: Analysis was conducted with National Administrative databases from Canadian Institute for Health Information for the fiscal year ending April 2008. Data sources included the Discharge Abstract Database which captures all acute care hospitalizations in Canada except Quebec; National Ambulatory Care Reporting System which includes same day surgery, emergency visits, and ambulatory services in hospital for Ontario. Both data sources were projected to the national level using census information from Statistics Canada. Non traumatic fractures identified included fractures of the hip, humerus, vertebral, wrist, other sites (ribs/sternum, pelvis, trunk, clavicle, scapula, femur, patella, tibia/fibula), and multiple sites (more than 1 above). Cases were identified by: 1) the most responsible diagnosis if fracture or osteoporosis, or 2) where fractures were pre-admission or post-admission coded if surgical intervention relating to fracture occurred. Traumatic fractures were excluded. Surgical interventions of interest were restricted to fixation, implantation of internal device, immobilization, reduction, repair, or partial excision. Costs were based on resource intensity weights for direct medical costs less physician billings. The additional costs for physician fees billed directly to the Ontario Health Insurance Policy included doctor visits in hospital and interventions (i.e., surgeon and anaesthesiologists fees for surgery, and professional and technical fees for diagnostic testing).
Result: In 2008 for Canada, there were 28,858 acute care hospitalizations due to hip fractures related to osteoporosis in Canada. Overall 59,478 acute care admissions occurred. The total costs of acute hospitalizations for osteoporosis and fractures related to osteoporosis related was $1.2 billion, with the cost of hip fracture alone being $618.6 million.
Conclusion: Osteoporosis is a chronic disease that affects a large segment of the adult population that increases the risk for expensive health care utilization for Canadians. Over $ 1.2 billion dollars is spent on acute care for fractures relating to osteoporosis each year, which represents a significant economic burden to Canada.
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