title: Direct costs of osteoporosis and hip fracture: an analysis for the Mexican Social Insurance Health Care System.
abstract: OBJECTIVE
  To compare costs of diagnosis and annual treatment of osteoporosis and hip fracture between the Instituto Nacional de Rehabilitación (INR) and the protocol used by the Seguro Popular de Salud (SPSS).
  
  
  METHODS
  Direct costs gathered in a prospective study with real cases at the INR are presented, and then this data is re-analyzed with the methodology and protocol for the SPSS to estimate the costs of those cases if treated with the SPSS protocol.
  
  
  RESULTS
  Important differences were found in the cost of hip fracture: the SPSS estimates ($37,363.73 MXN) almost double the INR cost ($20,286.86 MXN ). This discrepancy was caused by the different types of surgeries the INR and SPSS protocols call for (the SPSS assumes that all hip fractures will necessitate a hip replacement) and the cost of subsequent hospitalization. A prospective study at the SPSS is needed to validate these results.
  
  
  CONCLUSIONS
  Important differences were found between treatment of the same osteoporosis related problems at the INR and SPSS. We recommend revising the SPSS protocol to include less costly surgical treatments.
authors.affiliation: IMSS, Clinical Epidemiology Unit, Faculty of Medicine UNAM, Mexico.
authors.forename: Fernando
authors.initials: F
authors.lastname: Carlos
authors.forename: Patricia
authors.initials: P
authors.lastname: Clark
authors.forename: Humberto
authors.initials: H
authors.lastname: Maciel
authors.forename: Juan A
authors.initials: JA
authors.lastname: Tamayo
mesh_terms: D002985:Clinical Protocols; D003365:Costs and Cost Analysis; D017048:Health Care Costs; D006620:Hip Fractures / Q000175:diagnosis / Q000191:economics* / Q000601:surgery; D006801:Humans; D008800:Mexico; D010024:Osteoporosis / Q000150:complications*; D011446:Prospective Studies