Background Hip fractures are considered to be the most devastating consequence of osteoporosis. They require long hospitalizations, consume high health-care costs and represent an important cause of morbidity, disability and mortality1. However, a substantial gap exists between current evidence for best practices and its translation into optimal care of osteoporosis.
Objectives To carry out an analysis of the consumption of Health-care resources due to hip fractures in Portugal mainland
Methods The sample stratification (age, gender age, and residence) was designed to mirror the epidemiology of hip fractures in Portugal in 2011, as obtained from the Portuguese National Hospital Discharge Register, identifying ICD9 codes corresponding to osteoporotic hip fractures.25 NHS hospitals were selected to randomly identify 187 patients according to our stratification and to obtain informed consent from patients for an interview. A questionnaire regarding socio-demographic characteristics and the consumption of health-care during the first and second years after the hip fracture was conducted over the phone.
Results The mean age ate time of interview of the 187 patients (40 male and 147 female) was 80.5 years, with an average educational level of 3.5 years. At the end of first year after fracture, only 135 patients were alive (30 male and 105 female). Patients' average length of stay in hospital was 16.2 days. 96.2% of the patients had surgery immediately after hip fracture and 2.15% had a second surgery due to hip fracture in the second year. Regarding appointments due to hip fractures, 1.9% of the patients visited the orthopaedic surgeon in the first year and 0.3 in the second year. 2.2% visited the general practitioner in the first year and 1.2% in the second year due to the fracture. On average, patients had 29.2 sessions of physiotherapy during the first year. Regarding the treatment for osteoporosis only 16.6% of patients reported being prescribed bisphosphonates or other anti-osteoporotic agents. 29.4% were prescribed calcium and Vitamin D and 65.2% were prescribed for pain. During the first year, 34 patients were admitted to a rehabilitation home and stayed there for 61.2 days on average and 37 patients were admitted to nursing homes where they stayed an average of 270 days, this number decreased to 28 in the second year.
Conclusions Our two-year study demonstrated that health care costs of treating a hip-fracture patient are huge and that more needs to be done in order to prevent hip fractures in Portugal mailand. This study also highlights the savings to society if a hip fracture can be avoided.
Kanis, J.A. & Johnell, O. (2005). Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int., 16:229–38.
Acknowledgements To all the working group and the 25 hospitals. This study is supported by unrestricted grants from the Direção Geral da Saúde and Amgen.
Disclosure of Interest None declared