Direct costs of osteoporosis and hip fracture: an analysis for the Mexican healthcare system.
This study reports the direct costs related to osteoporosis and hip fractures paid for governmental and private institutions in the Mexican health system and estimates the impact of these entities on Mexico. We conclude that the economic burden due to the direct costs of hip fracture justifies wide-scale prevention programs for osteoporosis (OP).


METHODS
To estimate the total direct costs of OP and hip fractures in the Mexican Health care system, a sample of governmental and private institutions were studied. Information was gathered through direct questionnaires in 275 OP patients and 218 hip fracture cases. Additionally, a chart review was conducted and experts' opinions obtained to get accurate protocol scenarios for diagnoses and treatment of OP with no fracture. Microcosting and activity-based costing techniques were used to yield unit costs.


RESULTS
The total direct costs for OP and hip fracture were estimated for 2006 based on the projected annual incidence of hip fractures in Mexico. A total of 22,233 hip fracture cases were estimated for 2006 with a total cost to the healthcare system of US$ 97,058,159 for the acute treatment alone ($4,365.50 per case). We found considerable differences in costs and the way the patients were treated across the different health sectors within the country.


CONCLUSIONS
Costs of the acute treatment of hip fractures in Mexico are high and are expected to increase with the predicted increment of life expectancy and the number of elderly in our population.
Clark
P
P
Clinical Epidemiology Unit, CMN Siglo XXI IMSS, Faculty of Medicine UNAM, Mexico City, Mexico. patriciaclark@prodigy.net.mx
Carlos
F
F
Barrera
C
C
Guzman
J
J
Maetzel
A
A
Lavielle
P
P
Ramirez
E
E
Robinson
V
V
Rodriguez-Cabrera
R
R
Tamayo
J
J
Tugwell
P
P
D000368:Aged; D000369:Aged, 80 and over; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006620:Hip Fractures / Q000191:economics* / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics*; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics; D017149:Private Sector / Q000191:economics; D013222:State Medicine / Q000191:economics