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      Economic burden of osteoporotic fractures in Austria

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          Abstract

          Objective

          Osteoporotic fractures impose a huge economic burden on society. Though several cost of illness studies from other countries exist, no equivalent study has been conducted in Austria. Our study aims at assessing costs resulting from osteoporotic fractures in Austria in the year 2008 from a societal perspective.

          Methods

          We took both direct and indirect costs into consideration. Direct costs encompass medical costs such as expenses for pharmaceuticals, inpatient and outpatient medical care costs, as well as other medical services (e.g., occupational therapies). Non-medical direct costs include transportation costs and medical devices (e.g., wheel chairs or crutches). Indirect costs refer to costs of productivity losses due to absence of work. Moreover, we included costs for early retirement and opportunity costs of informal care provided by family members. For our analysis, we combined data of official statistics, expert estimates as well as unique patient surveys that are currently conducted in the course of an international osteoporotic fracture study in Austria.

          Results

          For the year 2008, the total annual financial burden incurred by osteoporotic fractures in Austria amounted to approx. €685.2 million, the largest fraction of which was due to the opportunity cost of family care (30.2%), followed by costs for hospitalization (26.6%).

          Conclusions

          The financial burden of osteoporotic fractures in Austria is substantial. Our findings may have implications for future economic analyses, and also support health care authorities in their decision making.

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          Most cited references27

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          Selective estrogen-receptor modulators -- mechanisms of action and application to clinical practice.

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            Economic implications of hip fracture: health service use, institutional care and cost in Canada.

            As the burden of illness associated with hip fracture extends beyond the initial hospitalization, a longitudinal 1 year cohort study was used to analyze levels of health service use, institutional care and their associated costs, and to examine patient and residency factors contributing to overall 1 year cost. Patients in the study were aged 50 year and over, and had been admitted to an acute care facility for hip fracture in the Hamilton-Wentworth region of Canada from 1 April 1995 to 31 March 1996. Health care resources assessed included initial hospitalization, rehospitalization, rehabilitation, chronic care, home care, long-term care (LTC) and informal care. Regression analysis was used to determine the effects of age, gender, residence, survival and days of follow-up on 1 year cost. The mean 1 year cost of hip fracture for the 504 study patients was 26,527 Canadian dollars (95% Cl: $24,564-$28,490). One year costs were significantly different for patients who returned to the community ($21,385), versus those who were transferred to ($44,156), or readmitted to LTC facilities ($33,729) (p < 0.001). Initial hospitalization represented 58% of 1 year cost for community-dwelling patients, compared with 27% for LTC residents. Only 59.4% of community-dwelling patients resided in the community 1 year following hip fracture, and 5.6% of patients who survived their first fracture experienced a subsequent hip fracture. Linear regression indicated place of residence, age and survival were all important contributors to 1 year cost (p < 0.001). While the average 1 year cost of care was $26,527, the overall cost varied depending on a patient's place of residence, age, and survival to 1 year. Annual economic implications of hip fracture in Canada are $650 million and are expected to rise to $2.4 billion by 2041.
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              Costs and quality of life associated with osteoporosis-related fractures in Sweden.

              This prospective observational data collection study assessed the cost and quality of life related to hip, vertebral and wrist fracture 1 year after the fracture, based on a patient sample consisting of 635 male and female patients surviving a year after fracture. Data regarding resource use and quality of life related to fractures was collected by questionnaires at baseline, 4 months and 12 months. Information was collected by the use of patients' records, register sources and by asking the patient. Quality of life was estimated with the EQ-5D questionnaire. Costs were estimated from a societal perspective, including direct and indirect costs. The mean fracture-related cost the year after a hip, vertebral and wrist fracture were estimated, in euros ( ), at 14,221, 12,544 and 2,147, respectively [converted from Swedish krona (SEK) at an exchange rate of 9.1268 SEK/ ]. The mean reduction in quality of life was estimated at 0.17, 0.26 and 0.06 for hip, vertebral and wrist fracture, respectively. Based on the results, the yearly burden of osteoporosis in Sweden could be estimated at 0.5 billion (SEK 4.6 billion). The patient sample for vertebral fracture was fairly small and included a high proportion of fractures leading to hospitalization, but they indicate a higher cost and loss of quality of life related to vertebral fracture than previously perceived.
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                Author and article information

                Journal
                Health Econ Rev
                Health Econ Rev
                Health Economics Review
                Springer
                2191-1991
                2012
                27 June 2012
                : 2
                : 12
                Affiliations
                [1 ]Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria
                [2 ]Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria
                [3 ]Association for the Promotion of Continuing Medical Education and Research, Vienna, Austria
                [4 ]I3 Innovus, Stockholm, Sweden
                [5 ]Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
                [6 ]Department for Public Health and Health Technology Assessment, UMIT–University for Health Sciences. Medical Informatics and Technology, Hall i.T, Austria
                [7 ]Department of Economics, Faculty of Business, Economics and Statistics, University of Vienna, Vienna, Austria
                Article
                2191-1991-2-12
                10.1186/2191-1991-2-12
                3423014
                22827971
                e9ba4c3f-28f9-4861-b3b4-9c3df716bb89
                Copyright ©2012 Dimai et al.; licensee Springer.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 9 March 2012
                : 27 June 2012
                Categories
                Research

                Economics of health & social care
                osteoporosis,costs of illness,austria,burden of illness
                Economics of health & social care
                osteoporosis, costs of illness, austria, burden of illness

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