title: Incidence and costs of hip fractures vs strokes and acute myocardial infarction in Italy: comparative analysis based on national hospitalization records.
abstract: OBJECTIVE
  As osteoporotic fractures are becoming a major health care problem in countries characterized by an increasing number of older adults, in this study we aimed to compare the incidence and costs of hip fragility fractures in Italian elderly people versus those of major cardiovascular diseases (strokes and acute myocardial infarctions [AMI]) occurring in the whole adult population.
  
  
  METHODS
  We analyzed hospitalization records maintained at the national level by the Italian Ministry of Health for the diagnosis of hip fractures (ICD-9-CM codes 820-821), AMI (code 410), hemorrhagic (codes 430, 431, 432) and ischemic strokes (codes 433-434), and TIA (code 435) between 2001-2005. Cost analyses were based on diagnosis-related groups.
  
  
  RESULTS
  The incidence of hip fractures in elderly people has increased (+12.9% between 2001 and 2005), as well as that of AMI (+20.2%) and strokes (hemorrhagic: +9.6%; ischemic: +14.7) occurring in the whole adult population; conversely, hospitalization due to TIA decreased by a rate of 13.6% between 2001 and 2005. In 2005, the hospital costs across the national health care system that were associated with hip fragility fractures in the elderly were comparable to those of strokes (both hemorrhagic and ischemic), which occurred in the whole Italian adult population. Moreover, these costs were higher than those generated by AMI and TIA. Rehabilitation costs following strokes reached about 3 billion Euros in 2005, but rehabilitative costs of hip fractures and AMI were comparable (about 530 million Euros in 2005).
  
  
  CONCLUSIONS
  The burden of hip fragility fractures in Italy is comparable to that of AMI and strokes.
authors.affiliation: University of Florence, Florence Italy. prisco.piscitelli@tiscali.it
authors.forename: Prisco
authors.initials: P
authors.lastname: Piscitelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Iolascon
authors.forename: Alberto
authors.initials: A
authors.lastname: Argentiero
authors.forename: Giovanna
authors.initials: G
authors.lastname: Chitano
authors.forename: Cosimo
authors.initials: C
authors.lastname: Neglia
authors.forename: Gemma
authors.initials: G
authors.lastname: Marcucci
authors.forename: Manuela
authors.initials: M
authors.lastname: Pulimeno
authors.forename: Marco
authors.initials: M
authors.lastname: Benvenuto
authors.forename: Santa
authors.initials: S
authors.lastname: Mundi
authors.forename: Valentina
authors.initials: V
authors.lastname: Marzo
authors.forename: Daniela
authors.initials: D
authors.lastname: Donati
authors.forename: Angelo
authors.initials: A
authors.lastname: Baggiani
authors.forename: Alberto
authors.initials: A
authors.lastname: Migliore
authors.forename: Mauro
authors.initials: M
authors.lastname: Granata
authors.forename: Francesca
authors.initials: F
authors.lastname: Gimigliano
authors.forename: Raffaele
authors.initials: R
authors.lastname: Di Blasio
authors.forename: Alessandra
authors.initials: A
authors.lastname: Gimigliano
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Renzulli
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Brandi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Distante
authors.forename: Raffaele
authors.initials: R
authors.lastname: Gimigliano
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis; D005260:Female; D006620:Hip Fractures / Q000191:economics* / Q000453:epidemiology / Q000534:rehabilitation; D006760:Hospitalization / Q000191:economics; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay / Q000191:economics; D008297:Male; D009203:Myocardial Infarction / Q000191:economics* / Q000453:epidemiology / Q000534:rehabilitation; D058866:Osteoporotic Fractures / Q000191:economics* / Q000453:epidemiology / Q000534:rehabilitation; D012189:Retrospective Studies; D017678:Sex Distribution; D020521:Stroke / Q000191:economics* / Q000453:epidemiology; D000071939:Stroke Rehabilitation