J Bone Metab.  2017 May;24(2):125-133. 10.11005/jbm.2017.24.2.125.

Healthcare Costs of Osteoporotic Fracture in Korea: Information from the National Health Insurance Claims Database, 2008-2011

• Kim HY
• Ha YC
• Kim TY
• Cho H
• Lee YK
• Baek JY
• Jang S

• KMID: 2379995
• DOI: http://doi.org/10.11005/jbm.2017.24.2.125

Abstract

BACKGROUND
The present study estimated healthcare costs of osteoporotic fractures including spine, hip, distal radius and humerus in Koreans over 50 years of age using national claims data.
METHODS
Korea National Health Insurance data between 2008 and 2011 was searched for all claims records of outpatient visits or hospital admissions of patients ≥50-year-of-age. Osteoporosis-related fractures were identified using certain the International Classification of Diseases, Tenth Revision codes and site-specific physician claims for procedures in a patient age cut-off value of 50 years. The healthcare costs included acute phase costs accounting for emergency medical care given immediately after fracture, costs due to further hospitalization and surgical procedures, physiotherapy sessions according to the site of the fracture, and outpatient visits in the year after discharge.
RESULTS
The total estimated healthcare costs of osteoporotic fractures in 2011 was $722 million. From 2008 to 2011, the total number and healthcare costs of osteoporotic fractures increased 28.9% (from 127,070 to 163,823) and 31.6% (from $549 million to $722 million), respectively. The portion of national health care expenditure was ranged from 2.3% in 2008 to 2.2% in 2011. The mean healthcare cost of osteoporotic fractures per person increased 2.1% from $4,321 in 2008 to $4,410 in 2011.The mean healthcare costs were highest for hip fractures followed by spine, humerus, and distal radius fractures.
CONCLUSIONS
Total Healthcare costs of osteoporotic fractures in South Koreans ≥50-year-of-age increased between 2008 and 2011. This trend will likely continue, which is an important health problem in the elderly population and economically.

Keyword

Health care costs; Korea; Osteoporotic fractures

MeSH Terms

Aged
Delivery of Health Care*
Emergencies
Health Care Costs*
Health Expenditures
Hip
Hip Fractures
Hospitalization
Humans
Humerus
International Classification of Diseases
Korea*
National Health Programs*
Osteoporotic Fractures*
Outpatients
Radius
Radius Fractures
Spine

Figure

• 

  Fig. 1 Age-standard incidence (per100,000) of osteoporotic fracture in Korean over 50 years old between 2008 and 2011.

• 

  Fig. 2 Estimated cost according to healthcare resource for osteoporotic fracture. (A) Total health care cost ($, million) and (B) Mean health care cost ($).

Reference

1. Johnell O, Kanis J. Epidemiology of osteoporotic fractures. Osteoporos Int. 2005; 16:Suppl 2. S3–S7.

2. Lee SR, Ha YC, Kang H, et al. Morbidity and mortality in Jeju residents over 50-years of age with hip fracture with mean 6-year follow-up: a prospective cohort study. J Korean Med Sci. 2013; 28:1089–1094.

3. Yoon HK, Park C, Jang S, et al. Incidence and mortality following hip fracture in Korea. J Korean Med Sci. 2011; 26:1087–1092.

4. Lix LM, Azimaee M, Osman BA, et al. Osteoporosis-related fracture case definitions for population-based administrative data. BMC Public Health. 2012; 12:301.

5. Siggeirsdottir K, Aspelund T, Jonsson BY, et al. Epidemiology of fractures in Iceland and secular trends in major osteoporotic fractures 1989-2008. Osteoporos Int. 2014; 25:211–219.

6. Cassell E, Clapperton A. A decreasing trend in fall-related hip fracture incidence in Victoria, Australia. Osteoporos Int. 2013; 24:99–109.

7. Sakuma M, Endo N, Oinuma T, et al. Incidence of osteoporotic fractures in Sado, Japan in 2010. J Bone Miner Metab. 2014; 32:200–205.

8. Johansson H, Clark P, Carlos F, et al. Increasing age- and sex-specific rates of hip fracture in Mexico: a survey of the Mexican Institute of Social Security. Osteoporos Int. 2011; 22:2359–2364.

9. Park C, Ha YC, Jang S, et al. The incidence and residual lifetime risk of osteoporosis-related fractures in Korea. J Bone Miner Metab. 2011; 29:744–751.

10. Ha YC, Kim TY, Lee A, et al. Current trends and future projections of hip fracture in South Korea using nationwide claims data. Osteoporos Int. 2016; 27:2603–2609.

11. Kim TY, Jang S, Park CM, et al. Trends of incidence, mortality, and future projection of spinal fractures in Korea using nationwide claims data. J Korean Med Sci. 2016; 31:801–805.

12. Kwon GD, Jang S, Lee A, et al. Incidence and mortality after distal radius fractures in adults aged 50 years and older in Korea. J Korean Med Sci. 2016; 31:630–634.

13. Park C, Jang S, Lee A, et al. Incidence and mortality after proximal humerus fractures over 50 years of age in South Korea: national claim data from 2008 to 2012. J Bone Metab. 2015; 22:17–21.

14. Hansen L, Mathiesen AS, Vestergaard P, et al. A health economic analysis of osteoporotic fractures: who carries the burden? Arch Osteoporos. 2013; 8:126.

15. Burge R, Dawson-Hughes B, Solomon DH, et al. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res. 2007; 22:465–475.

16. Boonen S, Singer AJ. Osteoporosis management: impact of fracture type on cost and quality of life in patients at risk for fracture I. Curr Med Res Opin. 2008; 24:1781–1788.

17. Borgström F, Zethraeus N, Johnell O, et al. Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int. 2006; 17:637–650.

18. Bouee S, Lafuma A, Fagnani F, et al. Estimation of direct unit costs associated with non-vertebral osteoporotic fractures in five European countries. Rheumatol Int. 2006; 26:1063–1072.

19. Budhia S, Mikyas Y, Tang M, et al. Osteoporotic fractures: a systematic review of U.S. healthcare costs and resource utilization. Pharmacoeconomics. 2012; 30:147–170.

20. Clark P, Carlos F, Barrera C, et al. Direct costs of osteoporosis and hip fracture: an analysis for the Mexican healthcare system. Osteoporos Int. 2008; 19:269–276.

21. Leslie WD, Lix LM, Finlayson GS, et al. Direct healthcare costs for 5 years post-fracture in Canada: a long-term population-based assessment. Osteoporos Int. 2013; 24:1697–1705.

22. Ohsfeldt RL, Borisov NN, Sheer RL. Fragility fracture-related direct medical costs in the first year following a nonvertebral fracture in a managed care setting. Osteoporos Int. 2006; 17:252–258.

23. Qu B, Ma Y, Yan M, et al. The economic burden of fracture patients with osteoporosis in western China. Osteoporos Int. 2014; 25:1853–1860.

24. Tamulaitiene M, Alekna V. Incidence and direct hospitalisation costs of hip fractures in Vilnius, capital of Lithuania, in 2010. BMC Public Health. 2012; 12:495.

25. Vestergaard P, Rejnmark L, Mosekilde L. Osteoporosis is markedly underdiagnosed: a nationwide study from Denmark. Osteoporos Int. 2005; 16:134–141.

26. Seo H, Yoon SJ, Yoon J, et al. Recent trends in economic burden of acute myocardial infarction in South Korea. PLoS One. 2015; 10:e0117446.