The health and economic consequences of osteopenia- and osteoporosis-attributable hip fractures in Germany: estimation for 2002 and projection until 2050

Abstract

The health and economic burden of osteopeniaand osteoporosis-attributable hip fractures (OHF) in Germany was estimated for 2002 and projected until 2050. We found 108,341 OHF resulting in 2,998 million Euros cost, which will more than double by the year 2050, calling for improvement and development of prevention strategies for OHF. Introduction This study aimed to estimate the health impact and the societal costs of OHF in Germany in the year 2002 and to extrapolate these estimates to the years 2020 and 2050. Methods We estimated OHF-attributable deaths, years of potential life lost (YPLL) and quality-adjusted life years lost (QALYs) using attributable fractions. Direct costs for acute treatment, rehabilitation, nursing care, non-medical costs and indirect costs for sickness absence, early retirement and mortality were estimated. All estimates were extrapolated to 2020 and 2050 using an estimation of future population composition and life expectancy. Results We found 108,341 OHF resulting in 3,485 deaths, 22,724 YPLL, 114,058 QALYs, 2,736 millions of Euros direct cost and 262 millions of Euros indirect costs. Projection to 2020 showed corresponding increases of 44%, 62%, 56%, 49%, 47% and 33%, whereas the projection to 2050 resulted in changes of 128%, 215%, 196%, 152%, 138% and 90%, respectively.Conclusions OHF have considerable impact on health and direct costs in the elderly. Both may strongly increase in future decades due to demographic changes, calling for improvement and development of effective strategies for preventing and dealing with OHF.

Hip fracture epidemiological trends, outcomes, and risk factors, 1970–2009

“…In Germany, for example, a call for improving and developing prevention strategies against hip fractures attributable to osteoporosis currently prevails because 2050 projections of this condition are expected to increase costs exponentially between 2020 and 2050 due to changing demographics 27. In Australia, the number of hip fractures is similarly expected to double over 29 years and quadruple in 56 years 28.…”

“…However, as the number of older adults living to higher ages increases globally, the total numbers of hip fracture cases and their related expenditures are likely to rise substantively 27. Moreover, even if some of the aforementioned data do not take into account more recent bone sparing pharmacologic interventions3 and other experimental therapies that may prevent hip bone loss,30 some published data reporting an age-specific flattening of the incidence of hip fractures,31,32 may be underestimates because they often exclude hip fracture injury cases or injuries that have occurred have not been accurately coded 3…”

Validation of an anatomy specific finite element model of Colles’ fracture

“…With a growing population of elderly people in industrialized countries, osteoporotic fractures are expected to increase over the coming decades (Reginster and Burlet, 2006;Konnopka et al, 2009). More than 50% of osteoporotic fractures occur in patients with a DEXA T-score greater than the diagnostic threshold of À2:5 SD (Sornay-Rendu et al, 2005;Siris et al, 2004;Schuit et al, 2004).…”

Cost of falls in old age: a systematic review

“…In the elderly, falls actually represent the leading contributor [5][6][7]. Within many countries, the fall-related burden of disease and costs in the elderly are expected to increase due to demographic changes [8][9][10].…”