Abstract
SummaryUsing a matched cohort design, we estimated the mean direct attributable cost in the first year after hip fracture in Ontario to be $36,929 among women and $39,479 among men. These estimates translate into an annual $282 million in direct attributable health-care costs in Ontario and $1.1 billion in Canada.IntroductionOsteoporosis is a major public health concern that results in substantial fracture-related morbidity and mortality. It is well established that hip fractures are the most devastating consequence of osteoporosis, yet the health-care costs attributed to hip fractures in Canada have not been thoroughly evaluated.MethodsWe determined the 1- and 2-year direct attributable costs and cost drivers associated with hip fractures among seniors in comparison to a matched non-hip fracture cohort using health-care administrative data from Ontario (2004–2008). Entry into long-term care and deaths attributable to hip fracture were also determined.ResultsWe successfully matched 22,418 female (mean age = 83.3 years) and 7,611 male (mean age = 81.3 years) hip fracture patients. The mean attributable cost in the first year after fracture was $36,929 (95 % CI $36,380–37,466) among women and $39,479 (95 % CI $38,311–$40,677) among men. These estimates translate into an annual $282 million in direct attributable health-care costs in Ontario and $1.1 billion in Canada. Primary cost drivers were acute and post-acute institutional care. Approximately 24 % of women and 19 % of men living in the community at the time of fracture entered a long-term care facility, and 22 % of women and 33 % of men died within the first year following hip fracture. Attributable costs remained elevated into the second year ($9,017 among women, $10,347 among men) for patients who survived the first year.ConclusionsWe identified significant health-care costs, entry into long-term care, and mortality attributed to hip fractures. Results may inform health economic analyses and policy decision-making in Canada.
Highlights
Osteoporosis is a major public health concern that results in substantial fracture-related morbidity and mortality [1,2,3]
24 % of women and 19 % of men living in the community at the time of fracture entered a longterm care facility, and 22 % of women and 33 % of men died within the first year following hip fracture
We identified significant health-care costs, entry into long-term care, and mortality attributed to hip fractures
Summary
Osteoporosis is a major public health concern that results in substantial fracture-related morbidity and mortality [1,2,3]. An estimated 30,000 hip fractures occur annually in Canada, with incidence projected to increase with our aging population [4]. It is well established that hip fractures are the most devastating consequence of osteoporosis, yet the health-care costs attributed. Osteoporos Int (2013) 24:659–669 to hip fractures in Canada have not been thoroughly evaluated. Comprehensive Canadian health-care costs attributed to hip fractures are needed to inform health economic analyses and guide policy decisions related to health resource allocation [8]. The main objective of our study was to determine the mean sex-specific direct health-care costs and outcomes attributable to hip fractures in Ontario seniors over a 1- and 2-year period
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