Osteoporosis International

, Volume 19, Issue 2, pp 243–249 | Cite as

Epidemiology of osteoporosis related fractures in Hungary from the nationwide health insurance database, 1999–2003

  • M. Péntek
  • C. Horváth
  • I. Boncz
  • Z. Falusi
  • E. Tóth
  • A. Sebestyén
  • I. Májer
  • V. Brodszky
  • L. Gulácsi
Original Article



The Hungarian national health insurance database was screened for fractures of patients aged 50–100, 1999–2003. On average, there were 343 hip, 1,579 forearm, 342 proximal humerus, 48 inpatient vertebral and 2,459 other fractures/100,000 inhabitants/year.


The incidence of fractures differs among populations. Our aim was to study the incidence of fractures in Hungary, focusing on classical osteoporotic sites and to compare the results with those of other European countries.


The Hungarian National Health Insurance Fund database, covering 100% of the population, was screened for fractures of patients aged 50–100, 1999–2003. The search of vertebral fractures was restricted to those admitted to hospital. A gender and age-matched comparison was performed with available data from Europe.


There were mean 343 hip, 1,579 forearm, 342 proximal humerus, 48 inpatient vertebral and 2,459 other fractures/100,000 inhabitants/year; the female/male ratio was between 1.2–2.4. Multiple fractures occurred in 23.1% of the cases. Hip fracture incidence in Hungary lies between the rates of northern and southern countries of Europe.


Our study offers nationwide epidemiological data on fractures in Hungary. The incidence of fractures increased by age, regardless of the type of fracture. Incidence of hip fractures in Hungary fits in the previously established geographic trends in Europe. Our results fulfil a need for fracture data from Central Europe.


Claims analysis Fracture Hungary Incidence Osteoporosis 



The authors are grateful for comments from Bengt Jonsson and Gisela Kobelt. Special thanks to Krisztián Horgos (NHIFA) for data analysis.


Center for Public Affairs Studies Foundation, Corvinus University of Budapest, Hungary.


  1. 1.
    Kanis JA, Johnell O, de Laet C et al (2002) International variations in hip fracture probabilities: implications for risk assessment. J Bone Min Res 17:1237–1244CrossRefGoogle Scholar
  2. 2.
    Johnell O, Kanis JA (2004) An estimate of the worldwide prevalence, mortality and disability associated with hip fracture. Osteoporos Int 15:897–902PubMedCrossRefGoogle Scholar
  3. 3.
    Johnell O, Kanis J (2005) Epidemiology of osteoporotic fractures. Osteoporos Int 16:S3–S7PubMedCrossRefGoogle Scholar
  4. 4.
    Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733PubMedCrossRefGoogle Scholar
  5. 5.
    Johnell O, Borgstrom F, Jonsson B et al (2007) Latitude, socioeconomic prosperity, mobile phones and hip fracture risk. Osteoporos Int 18:333–337PubMedCrossRefGoogle Scholar
  6. 6.
    Herrera A, Martínez AA, Ferrandez L et al (2006) Epidemiology of osteoporotic hip fractures in Spain. Int Orthop 30:11–14PubMedCrossRefGoogle Scholar
  7. 7.
    Maravicz M, Bihan CL, Landais P et al (2005) Incidence and cost of osteoporotic fractures in France during 2001. A methodological approach by the national hospital database. Osteoporos Int 16:1475–1480CrossRefGoogle Scholar
  8. 8.
    Cheng TM (2003) Taiwan’s new national health insurance program: genesis and experience so far. Health Aff (Millwood) 22:61–76CrossRefGoogle Scholar
  9. 9.
    Chie WC, Yang RS, Liu JP et al (2004) High incidence of hip fracture rate in Taiwan: estimated of a nationwide health insurance database. Osteoporos Int 15:998–1002PubMedCrossRefGoogle Scholar
  10. 10.
    Yang NP, Deng CY, Chou YJ et al (2006) Estimated prevalence of osteoporosis from a Nationwide Health Insurance database in Taiwan. Health Policy 75:329–337PubMedCrossRefGoogle Scholar
  11. 11.
    Kanis JA, Oden A, Johnell O et al (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12:417–427PubMedCrossRefGoogle Scholar
  12. 12.
    Gulacsi L, David T, Dozsa C (2002) Pricing and reimbursement of drugs and medical devices in Hungary. Eur J Health Econom 3:271–278CrossRefGoogle Scholar
  13. 13.
    Boncz I, Nagy J, Sebestyen A et al (2004) Financing of health care services in Hungary. Eur J Health Econom 5:252–258CrossRefGoogle Scholar
  14. 14.
  15. 15.
    Gullberg B, Johnell O, Kanis JA (1997) World-wide projection for hip fracture. Osteoporos Int 7:407–413PubMedCrossRefGoogle Scholar
  16. 16.
    Kanis JA, Johnell O, Oden A et al (2005) Intervention thresholds for osteoporosis in men and women: a study based on data from Sweden. Osteoporos Int 16:6–14PubMedCrossRefGoogle Scholar
  17. 17.
    Lesic A, Jarebinski M, Pekmezovic T et al (2006) Epidemiology of hip fractures in Belgrade, Serbia Montenegro, 1990–2000. Arch Orthop Trauma Surg 127:179–183PubMedCrossRefGoogle Scholar
  18. 18.
    Palvanen M, Kannus P, Niemi S et al (2006) Update in the epidemiology of proximal humerus fractures. Clin Orthop Rel Res 442:87–92CrossRefGoogle Scholar
  19. 19.
    Koeck CM, Schwappach DL, Niemann FM et al (2001) Incidence and costs of osteoporosis-associated hip fractures in Austria. Wien Klin Wochenschr 113:371–377PubMedGoogle Scholar
  20. 20.
    Finnern HW, Sykes DP (2003) The hospital cost of vertebral fractures in the EU: estimates using national datasets. Osteoporosis Int 14:429–436CrossRefGoogle Scholar
  21. 21.
    Schwartz AV, Kelsey JL, Maggi S et al (1999) International variation in the incidence of hip fractures: cross national project on osteoporosis for the World Health Organisation Program for Research on Aging. Osteoporos Int 9:242–253PubMedCrossRefGoogle Scholar
  22. 22.
    Somogyi P, Bossányi A, Kricsfalusy M et al (2000) Az osteoporoticus eredetű csonttörések számának becslése Magyarországon. Ca és Csont 3:111–117Google Scholar
  23. 23.
    Johnell O, Gullberg B, Kanis A (1997) The hospital burden of vertebral fractures in Europe: a study of national register sources. Osteoporosis Int 7:138–144CrossRefGoogle Scholar
  24. 24.
    Staa TP, Dennison EM, Leufkens HGM et al (2001) Epidemiology of fractures in England and Wales. Bone 29:517–522PubMedCrossRefGoogle Scholar
  25. 25.
    Kanis JA, Johnell O, Oden A et al (2000) Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int 11:669–674PubMedCrossRefGoogle Scholar
  26. 26.
    Misra A, Kapur R, Maffulli N (2001) Complex proximal humeral fractures in adults — a systematic review of management. Injury 32:363–372PubMedCrossRefGoogle Scholar
  27. 27.
    Helmy N, Hintermann B (2006) New trends in the treatment of proximal humerus fractures. Clin Orthop Relat Res 442:100–108PubMedCrossRefGoogle Scholar
  28. 28.
    Johnell O, Kanis JA, Jonsson B et al (2005) The burden of hospitalised fractures in Sweden. Osteoporos Int 16:222–228PubMedCrossRefGoogle Scholar
  29. 29.
    O’Neill TW, Felsenberg D, Varlow J et al (1996) The prevalence of vertebral deformity in european men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res 11:1010–1018PubMedCrossRefGoogle Scholar
  30. 30.
    Poor G, Kiss C, Szilagyi M et al (1997) Prevalence of vertebral deformity in Hungary: the European Vertebral Osteoporosis Study. Orv Hetil 138:2647–2652PubMedGoogle Scholar
  31. 31.
    Roy DK, O’Neill TW, Finn JD et al (2003) Determinants of incident vertebral fracture in men and women: results from the European Prospective Osteoporosis Study (EPOS). Osteoporos Int 14:19–26PubMedCrossRefGoogle Scholar
  32. 32.
    O’Neill TW, Cockerill W, Matthis C et al (2004) Back pain, disability, and radiographic vertebral fracture in European women: a prospective study. Osteoporos Int 15:760–765PubMedCrossRefGoogle Scholar
  33. 33.
    Zethraeus N, Borgstrom F, Strom O et al (2006) Cost-effectiveness of the treatment and prevention of osteoporosis-a review of the literature and a reference model. Osteoporos Int. DOI  10.1007/s00198-006-0257-0

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2007

Authors and Affiliations

  • M. Péntek
    • 1
  • C. Horváth
    • 2
  • I. Boncz
    • 3
  • Z. Falusi
    • 3
  • E. Tóth
    • 1
  • A. Sebestyén
    • 4
  • I. Májer
    • 5
  • V. Brodszky
    • 5
  • L. Gulácsi
    • 5
  1. 1.RheumatologyFlór Ferenc County HospitalKistarcsaHungary
  2. 2.First Department of MedicineSemmelweis UniversityBudapestHungary
  3. 3.National Health Insurance Fund AdministrationBudapestHungary
  4. 4.Baranya County Health Insurance Fund AdministrationPécsHungary
  5. 5.Health Economics and Technology Assessment Research CentreCorvinus University of BudapestBudapestHungary

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