No 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.

The study analyzes whether the COVID-19 pandemic affects annual hip fractures (HF) rates and weekly emergency department (ED) consultations and hospitalizations due to trauma in older people. During the COVID-19 pandemic, HF rates and ED consultation and hospitalization rates due to trauma decreased. Purpose To describe the effect of the COVID-19 pandemic on annual HF rates and weekly ED consultation and hospitalization rates due to trauma in Chile in 2020, compared to 2016-2019. Methods A retrospective study was conducted based on data from Chile's Department of Statistics and Health Information. Annual HF admissions, weekly ED consultations and hospitalizations due to trauma were described for the years 2016-2020, grouping the years 2016-2019 to compare them with 2020. Rates were calculated per 100.000 inhabitants.Results From 2016 to 2020, a total of 35.050 patients aged ≥ 65 years were hospitalized in Chile with a diagnosis of HF, with the lowest number of admissions in 2020 (6.423). During 2020, annual HF rate was 273.6/100.000, representing a decrease of 18.5% compared to the average annual HF rate of 2016-2019 (335.7/100.000). In 2020, the weekly consultation rate due to trauma in older adults decreased by 20.8% and the weekly hospitalization rate due to trauma in older adults decreased by 18.5%. Conclusion During the COVID-19 pandemic, osteoporotic HF rates decreased, along with ED consultation and hospitalization rates due to trauma in older adults. This could be a result of mobility restrictions and a significant increase in the proportion of self-reliant older adults in the Chilean population.

Patients with hypothyroidism may have a minor increase in their bleeding tendency, causing easy bruising and menorrhagia. There is a positive correlationCorrespondencia a: Dr. Iván Quevedo l. Avenida Andalué N° 1825; San Pedro de la Paz, Concepción-Chile. E mail: equevedo@udec.cl E l hipotiroidismo primario es una de las patologías crónicas más frecuentes de la población adulta. Estudios epidemiológicos muestran que en Chile la prevalencia del hipotiroidismo corresponde a 7% 1 , cifra algo superior a las comunicadas en otros lugares del mundo, donde la prevalencia oscila entre 3 y 6% 2,3 . Los casos avanzados de hipotiroidismo primario no ofrecen mayor dificultad diagnosticada, dado que los síntomas y signos dan cuenta de una historia de cansancio fácil, astenia, bradipsiquia e intolerancia al frío. El paciente refiere presentar constipación, aumento de peso y dolores osteomusculares inespecíficos, y en las mujeres puede agregarse hipermenorrea o amenorrea. En el examen físico, llamará la atención la facie vultuosa, palidez variable de la piel, cejas ralas, cabello grueso y voz grave 4 . Sin