Osteoporosis International

, Volume 16, Issue 4, pp 359–371

Health care utilization and expenditures in the United States: a study of osteoporosis-related fractures

  • Lucinda Strycker Orsini
  • Matthew D. Rousculp
  • Stacey R. Long
  • Shaohung Wang
Original Article

DOI: 10.1007/s00198-004-1694-2

Cite this article as:
Orsini, L.S., Rousculp, M.D., Long, S.R. et al. Osteoporos Int (2005) 16: 359. doi:10.1007/s00198-004-1694-2

Abstract

Background: More than 1.5 million fractures occur due to osteoporosis each year. This study examines the annual health care utilization and associated expenditures of osteoporotic patients who sustain a new fragility fracture and of those without a new fracture. Methods and procedures: The study sample from commercial claims databases consisted of patients enrolled in US plans between January 1, 1997, and December 31, 2001. Patients with both an osteoporosis diagnosis and a related fracture were classified as “osteoporosis with concurrent fracture”; all other osteoporosis patients were classified as “osteoporosis without concurrent fracture.” Annual utilization and expenditures for the concurrent-fracture cohort were compared with those without concurrent fracture, as well as with a group of patients without osteoporosis (controls) that was matched to the concurrent-fracture cohort based on age, gender, US region, health plan type, and length of enrollment. Exponential conditional mean models were used to compute regression-adjusted total expenditures across the groups. The differences in adjusted expenditures were used to generate the economic burden-of-illness estimates. Results: Osteoporosis patients with concurrent fracture incurred more than twice the overall health care expenditures in the study period, compared with those without fracture (US $15,942 vs $6,476), and nearly three times those of the control group (US $15,942 vs $4,658). Approximately 25% of the overall health care expenditures (US $4,014 of $15,942) for the concurrent-fracture group were osteoporosis-related expenditures, leading to the conclusion that comorbid conditions in osteoporosis patients with concurrent fracture contribute significantly to overall health care costs. Some of these comorbidity-related costs were likely due to pain-related disorders, which occurred significantly more frequently in the concurrent-fracture cohort than in the other groups. Conclusion: Osteoporosis-related expenditures, particularly those related to fracture, were substantial. However, non-osteoporosis-related expenditures to treat comorbid conditions constituted 75% of the overall health care costs in the year after an osteoporosis-related fracture, which warrants further investigation.

Keywords

Burden of illnessComorbidityCostsFractureSevere osteoporosis

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2004

Authors and Affiliations

  • Lucinda Strycker Orsini
    • 1
  • Matthew D. Rousculp
    • 2
  • Stacey R. Long
    • 3
  • Shaohung Wang
    • 1
  1. 1.Outcomes Research & EconometricsMedstatCambridgeUSA
  2. 2.Eli Lilly and CompanyIndianapolisUSA
  3. 3.MedstatHampdenUSA