PMS38 - HEALTH CARE RESOURCE UTILIZATION AND DIRECT MEDICAL COST FOR INPATIENTS WITH OSTEOPOROTIC FRACTURE IN TIANJIN, CHINA

Abstract

Estimate the 12-month osteoporosis-related health care resource utilization and direct medical cost. Data were obtained from the Tianjin Urban Employee Basic Medical Insurance database (2008-2011). Patients were aged ≥50 years, with their first osteoporotic fracture hospitalization from January 1, 2009 to December 31, 2010, and had 12-month continuous enrollment before and after the hospitalization. Both osteoporosis-related health resource utilization and direct medical cost were estimated during the 12-month follow-up period. Ordinary least-square regression models were applied to identify factors associated with annual direct medical cost and inpatient length of stay (LOS). 1839 patients were included (mean age 67.2 years, 58.2% female, 89.0% retired). Patients had 1.27±0.8 (mean±SD) hospitalizations due to osteoporotic fractures, and average LOS was 18.0±14.4 days/admission. Of all patients, 19.5% experienced ≥1 osteoporotic fracture hospitalizations within 12 months after the first one; 45.2% had ≥1 osteoporosis-related outpatient visit (7.6±8.1). The average direct medical cost was 19917 CNY/hospital admission and 102 CNY/outpatient visit. The total mean direct medical cost was 25553 CNY/patient-year; the highest cost components were medical device (41.5%), drug (28.1%), examination (11.0%), and treatment (8.2%). Cost increased as age increased but differences were not significant. Cost for female patients were higher (p=0.031); patients with hip, lower limb, and multi-location fractures were more likely to have a higher cost and patients with rib fractures were more likely to have a lower cost compared to arm fracture patients (p<0.05). Older patients (≥70 years), those with more comorbidities, and those with hip and lower limb fractures had longer LOS. Among patients with osteoporotic fracture hospitalizations, females and those with hip, lower limb, and multi-location fractures were more likely to incur more direct medical cost, and LOS was longer for older patients, those with more comorbidities, and those with hip and lower limb fractures.