Abstract
The osteoporotic hip fracture is associated with a high impact on morbidity, mortality, and health expenditure. The Chilean health system is made up of a mixed care system, with the public system called FONASA and the private system called ISAPRE. The people with lower incomes are listed on FONASA and correspond to 80.8% of the population. The aims of this study were to describe the incidence of hip fracture in the Chilean population from the age of 45 years and to estimate the direct medical cost of this disease. The records of the Department of the Health Statistics and Information of the Ministry of Health were used, from which the number of national hospital discharges due to hip fractures was obtained (codes S720, S721, and S722 of the ICD-10), in adults aged 45 years or older, by sex, from 2006 to 2017. The cost of osteoporotic hip fracture treatment in the public health system was obtained from the data of the surgical treatment according to the payment method associated with diagnosis (PAD bonus). A surgical intervention budget was used in a private clinic to calculate the direct cost of osteoporotic hip fracture in the private system. Between 2006 and 2017, the number of hospital discharges due to osteoporotic hip fracture in adults aged 45 years and older has increased progressively, registering 9.583 hospital discharges for this cause in 2017, which corresponds to 50% more than those recorded in 2006, with a 3 : 1 F/M ratio. The mean annual rate of hip fractures is 148.7 per 100,000 inhabitants aged above 45 years. The individual cost of managing an osteoporotic hip fracture in the public system was USD$ 3,919, and USD$ 9,092 in the private health system. The incidence of hip fracture was comparable with data from Southern European countries and from neighboring countries, such as Argentina and Uruguay. Hospitalization cost of hip fracture in Chile was 34 million USD per year. Hip fracture constitutes a serious healthcare problem in Chile, and efforts for the prevention and management of osteoporosis are needed.
Highlights
Introduction eChilean population is in an accelerated period of aging
Between 2006 and 2017, the number of hospital discharges due to osteoporotic hip fracture (S72) in adults aged 45 years or more has increased progressively, registering 9.583 hospital discharges for this cause in 2017, which corresponds to 50% more than those recorded in 2006
The population ages quickly; in 2015, the United Nations report on the aging of the world’s population indicated that the fastest increase in the number of older people will occur in Latin America and the Caribbean, with the increase in the population of 60 years being estimated at 71% or greater by 2050 [25]
Summary
Introduction eChilean population is in an accelerated period of aging. In 2017, the Chilean population had 17.5 million inhabitants, of which 16.2% (2.8 million) were 60 years old or older [1].e aging index, which corresponds to the people aged 65 years and older in proportion to the people under 15 years old, shows that by 2050, the proportion is projected to be 177 persons of 65 years old and older per 100 persons under 15 years old [2]. In 2017, the Chilean population had 17.5 million inhabitants, of which 16.2% (2.8 million) were 60 years old or older [1]. It is estimated that by 2050, the total population of the country will be 21.6 million inhabitants, of which 32% (6.9 million) will be 60 years old or older [2]. Wrist, and hip fractures are considered the classic osteoporotic fractures [6], being the hip fracture the one with the greatest economic impact. It represents only 18% of all osteoporotic fractures, it represents more than 40% of the health expenditure associated with osteoporotic fractures [5, 7]. In 2000, approximately 9 million osteoporotic fractures occurred worldwide, and of these over 70% affected were women [5, 7]
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