Direct Costs of Hip Fractures in Patients Over 60 Years of Age in Belgium (original) (raw)
Abstract
Objective: Osteoporosis-related costs are now considered a major burden for health authorities in most developed countries. An accurate and exhaustive evaluation of these costs would be a major contribution to health economic studies evaluating the efficiency of screening and prevention strategies. Osteoporosis is the most frequent underlying cause of femoral neck fractures in the elderly; these fractures weigh heavily on healthcare budgets. However, in Belgium, very few data on the financial burden of hip fractures are available and no updated estimates have been made. The goal of this paper is to estimate the direct medical expenditures associated with hip fractures in Belgium in 1996.
Design and setting: This 1-year population-based cross-sectional study is conducted from the social security perspective. The target population in this study are men and women aged 60 years and over.
Patients and participants: We selected patients who had been hospitalised for a hip fracture during the year 1996 who were also affiliated with a registered social security organisation (covering 25% of the Belgian population). The sample constituted 2374 patients.
Interventions: For each of these patients, we collected an exhaustive and detailed list of healthcare resource use as well as nursing home admissions following the hip fracture event. Cost items investigated in the analysis were inpatient hospital costs and outpatient costs. Mean annual costs per case recorded in the sample were then extrapolated to the whole country on the basis of an exhaustive list of diagnoses having lead to all countrywide hospitalisations (1700000 hospital stays/year).
Main outcome measures and results: The mean hospital inpatient costs for hip fracture were evaluated at 332 148 Belgian francs (BeF) [$US8977] per case and BeF4 367 746 200 ($US118 047 194) for the whole country (10 million inhabitants). Patients with a hip fracture experienced an annual BeF27 825 ($US752) extra outpatient cost during the year following this fracture event, after correcting for costs related to additional comorbidity already present before the hip fracture. Finally, after a proximal femoral neck fracture, the rate of nursing home admission was higher, both for men and women at any age compared with age- and gendermatched population.
Conclusions: With a total cost (acute hospital and outpatient costs) of BeF4 667 894 950 ($US126 159 323) per year in Belgium, proximal femoral neck fracture should be considered a major health economic problem and appropriate measures to prevent this disease should be rapidly undertaken.
Access this article
Subscribe and save
- Get 10 units per month
- Download Article/Chapter or eBook
- 1 Unit = 1 Article or 1 Chapter
- Cancel anytime Subscribe now
Buy Now
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
Instant access to the full article PDF.
Similar content being viewed by others
References
- Keene GS, Parker MJ, Pryor GA. Mortality and morbidity after hip fractures. BMJ 1993; 307: 1219–50
Article Google Scholar - Chrischilles E, Shireman T, Wallace R. Costs and health effects of osteoporotic fractures. Bone 1994; 15: 377–86
Article PubMed CAS Google Scholar - Phillips S, Fox N, Jacobs J, et al. The direct medical costs of osteoporosis for American women aged 45 and older. Bone 1988; 9: 271–9
Article PubMed CAS Google Scholar - Melton LJ. Hip fractures: a worldwide problem today and tomorrow. Bone 1993; 14: S1–8
Article Google Scholar - Gillet P, Gosset C, Reginster JY. Direct social costs of osteoporotic hip fractures in Belgium [abstract]. Calcif Tissue Int 1997; 61: 499
Google Scholar - Nagant de Deuxchaisnes C, Devogelaer JP. Increase in the incidence of hip fractures and of the ratio of trochanteric to cervical hip fractures in Belgium. Calcif Tissue Int 1988; 42: 201–3
Article Google Scholar - Gillet P, Gosset C, Reginster JY. Osteoporosis: the interest of a prospective vision [abstract]. Calcif Tissue Int 1997; 61: 499
Google Scholar - Emeriau JP, Maurette P, Tiret L, et al. Morbidité et cout des fractures du col. Encyclopédie Médo Chir 1991; 98: 31–6
Google Scholar - Prier A. Incidence et conséquences socio-économiques des fractures du col du fémur. Sem Hop 1990; 66: 2144–6
Google Scholar - Baudoin C. The cost of osteoporosis in France. Rev Rhum Engl Ed 1997; 64: 441–2
PubMed CAS Google Scholar - Baudoin C, Fardellone P, Bean K, et al. Clinical outcomes and mortality after hip fractures: a 2-year follow-up study. Bone 1996; 18: 149–57
Article Google Scholar - Levy E. Cost analysis of osteoporosis related to untreated menopause. Clin Rheum 1989; 8 Suppl. 2: S76–82
Article Google Scholar - Lyritis G. Epidemiology and socioeconomic cost of osteoporotic fractures in Greece. Calcif Tissue Int 1992; 51: 93–4
Article PubMed CAS Google Scholar - Lopez Vaz A. Epidemiology and costs of osteoporotic hip fractures in Portugal. Bone 1993; 14 Suppl. 3: S9–10
Google Scholar - Sernbo I, Johnell O. Consequences of a hip fracture: a prospective study over 1 year. Osteoporos Int 1993; 3: 148–53
Article PubMed CAS Google Scholar - Schürch MA, Rizzoli R, Mermillod B, et al. A prospective study on socioeconomic aspects of fracture of the proximal femur. J Bone Miner Res 1996; 11: 1935–42
Article PubMed Google Scholar - Lippuner K, von Overbeck J, Perrelet R, et al. Incidence and direct medical costs of hospitalizations due to osteoporotic fractures in Switzerland. Osteoporos Int 1997; 7: 414–25
Article PubMed CAS Google Scholar - Kramer AM, Steiner JF, Schlenker RE, et al. Outcomes and costs after hip fracture and stroke: a comparison of rehabilitation settings. JAMA 1997; 277: 396–404
Article PubMed CAS Google Scholar - Randell A, Sambrook PN, Nguyen TV. Direct clinical and welfare costs of osteoporotic fractures in elderly men and women. Osteoporos Int 1995; 5: 427–32
Article PubMed CAS Google Scholar - Lane A. Direct costs of osteoporosis for New Zealand women. Pharmacoeconomics 1996; 9: 231–45
Article PubMed CAS Google Scholar - Reginster JY. Cost effectiveness of treatments in osteoporosis. J Rheumatol 1996; 23: 1312–3
PubMed CAS Google Scholar - Dere W, Avouac B, Boers M, et al. Recommendations for the health economics analysis to be performed with a drug to be registered in prevention or treatment of osteoporosis. Calcif Tissue Int 1998; 63: 93–7
Article PubMed CAS Google Scholar
Author information
Authors and Affiliations
- WHO Collaborating Center for Public Health Aspects of Osteoarticular Disorders, Liege, Belgium
Jean-Yves Reginster, Wafa Ben Sedrine, Geoffrey Brands, Olivier Ethgen, Cécile de Froidmont & Christiane Gosset - Department of Public Health and Epidemiology, University of Liège, Liège, Belgium
Jean-Yves Reginster, Wafa Ben Sedrine, Geoffrey Brands, Olivier Ethgen, Cécile de Froidmont & Christiane Gosset - Bone and Cartilage Unit, CHU Centre Ville, University of Liège, 45 Quai Godefroid Kurth (+9), 4020, Liège, Belgium
Jean-Yves Reginster - Department of Neurology, Georgetown University Medical Center, Washington, DC, USA
Jean-Yves Reginster - Public Health School, University of Liège, Liège, Belgium
Pierre Gillet - Medical Direction, University Hospital, University of Liège, Liège, Belgium
Pierre Gillet
Authors
- Jean-Yves Reginster
You can also search for this author inPubMed Google Scholar - Pierre Gillet
You can also search for this author inPubMed Google Scholar - Wafa Ben Sedrine
You can also search for this author inPubMed Google Scholar - Geoffrey Brands
You can also search for this author inPubMed Google Scholar - Olivier Ethgen
You can also search for this author inPubMed Google Scholar - Cécile de Froidmont
You can also search for this author inPubMed Google Scholar - Christiane Gosset
You can also search for this author inPubMed Google Scholar
Corresponding author
Correspondence to Jean-Yves Reginster.
Rights and permissions
About this article
Cite this article
Reginster, JY., Gillet, P., Sedrine, W.B. et al. Direct Costs of Hip Fractures in Patients Over 60 Years of Age in Belgium.Pharmacoeconomics 15, 507–514 (1999). https://doi.org/10.2165/00019053-199915050-00008
- Published: 11 October 2012
- Issue Date: May 1999
- DOI: https://doi.org/10.2165/00019053-199915050-00008