title: Burden of First Osteoporotic Hip Fracture in Spain: A Prospective, 12-Month, Observational Study.
abstract: The purpose of this study was to estimate the burden of osteoporotic fractures beyond the hospitalization period covering up to the first year after the fracture. This was a prospective, 12-month, observational study including patients aged ≥65 years hospitalized due to a first low-trauma hip fracture, in six Spanish regions. Health resource utilization (HRU), quality of life (QoL) and autonomy were collected and total costs calculated. Four hundred and eighty seven patients (mean ± SD age 83 ± 7 years, 77 % women) were included. Twenty-two percent of patients reported a prior non-hip low-trauma fracture, 16 % were receiving osteoporotic treatment at baseline, and 3 % had densitometry performed (1.8 % T-score ≤-2.5). Sixteen percent of patients died (women 14 %; men 25 %; p = 0.0011) during the first year. Mean hospital stay was 11.8 ± 7.9 days and 95.1 % of patients underwent surgery. Other relevant HRUs were: outpatient visits in 78 % of patients (mean 9.2 ± 9.7); walking aids, 58.7 %; rehabilitation facilities, 35.5 % (28.7 ± 41.2 sessions); and formal and informal home care, 22.2 % (49.6 ± 72.2 days) and 53.4 % (77.1 ± 101.0 h), respectively. Mean direct cost was €9690 (95 % confidence interval: 9184-10,197) in women and €9019 (8079-9958) in men. Main cost drivers were: first hospitalization episode (women €7067 [73 %]; men €7196 [80 %]); outpatient visits (€1323 [14 %]; €997 [11 %]); and home care (€905 [9 %]; €767 [9 %]). QoL and autonomy showed a marked decrease during hospitalization, not entirely recovered at 12 months (p < 0.05 vs. baseline for EQ-5D, Harris hip score and modified Barthel index). In a Spanish setting, osteoporotic hip fractures incur a high societal and economic cost, mainly due to the first hospitalization HRU, but also due to subsequent outpatient visits and home care.
authors.affiliation: Servicio de COT, Complejo Hospitalario Universitario de Santiago, Calle Choupana s/n, ES-15702, Santiago De Compostela, A Coruña, Spain. jrcaeiro@telefonica.net.
authors.forename: Jose Ramón
authors.initials: JR
authors.lastname: Caeiro
authors.affiliation: Hospital Universitari Mútua de Terrassa, Plaça del Dr. Robert 5, ES-08221, Terrassa, Barcelona, Spain.
authors.forename: Agustí
authors.initials: A
authors.lastname: Bartra
authors.affiliation: Hospital Valle de los Pedroches, Calle de Juan del Rey Calero s/n, ES-14400, Pozoblanco, Córdoba, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Mesa-Ramos
authors.affiliation: Hospital Alto Deba, Calle Nafarroa Etorbidea 16, ES-20500, Arrasate-Mondragón, Guipúzcoa, Spain.
authors.forename: Íñigo
authors.initials: Í
authors.lastname: Etxebarría
authors.affiliation: Hospital Universitario Fundación Alcorcón, Calle Budapest 1, ES-28922, Alcorcón, Madrid, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Montejo
authors.affiliation: Hospital Reina Sofía de Córdoba, Avda. Menéndez Pidal s/n, ES-14004, Córdoba, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Carpintero
authors.affiliation: Amgen S.A., World Trade Center Barcelona, Moll de Barcelona s/n, Edif. Sud, Planta 7, ES-08039, Barcelona, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Sorio
authors.affiliation: Amgen S.A., World Trade Center Barcelona, Moll de Barcelona s/n, Edif. Sud, Planta 7, ES-08039, Barcelona, Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: Gatell
authors.affiliation: Amgen S.A., World Trade Center Barcelona, Moll de Barcelona s/n, Edif. Sud, Planta 7, ES-08039, Barcelona, Spain.
authors.forename: Andrea
authors.initials: A
authors.lastname: Farré
authors.affiliation: Amgen S.A., World Trade Center Barcelona, Moll de Barcelona s/n, Edif. Sud, Planta 7, ES-08039, Barcelona, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Canals
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006620:Hip Fractures / Q000191:economics / Q000628:therapy*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000628:therapy; D058866:Osteoporotic Fractures / Q000191:economics / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life; D013030:Spain
keywords: Autonomy; Cost; Hip fracture; Osteoporosis; Quality of life