Hospitalisations for fracture and associated costs between 2000 and 2009 in Ireland: a trend analysis
In Ireland, the absolute numbers of hospitalisations for all osteoporotic-type fractures including hip fractures increased between 2000 and 2009 along with the mean length of stay. The cost of hospitalisations for these fractures also increased between 2003 and 2008.
The purposes of the study were to carry out a trend analyses of the total number of osteoporotic-type fractures in males and females aged 50 years and over in Ireland between 2000 and 2009 and to project the number of osteoporotic-type fractures in the Republic of Ireland expected by 2025.
Age- and gender-specific trends in the absolute numbers and direct age-standardised rates of hospitalisations for all osteoporotic-type fractures in men and women ≥50 years were analysed, along with the associated hospitalisation costs and length of stay using the Hospital In-Patient Enquiry system database. Future projections of absolute numbers of osteoporotic-type fractures in years 2015, 2020 and 2025 were computed based on the 2009 incidence rates applied to the projected populations.
Between 2000 and 2009, the absolute numbers of all osteoporotic-type fractures increased by 12 % in females and by 15 % in males while the absolute numbers of hip fractures increased by 7 % in women and by 20 % in men. The age-specific rates for hip fractures decreased in all age groups with the exception of the 55–59-year age group which showed an increase of 4.1 % (p = 0.023) within the study period. The associated hospitalisation costs and length of stay increased. Assuming stable age-standardised incidence rates from 2009 over the next 20 years, the number of all types of osteoporotic-type fractures is projected to increase by 79 % and the number of hip fractures is expected to increase by 88 % by 2025.
Hospitalisations for osteoporotic-type fractures continued to increase in Ireland. Hip fractures increased by 7 % in women and 20 % in men.
KeywordsBed days Costs Fractures Osteoporosis Projections Trends
We would like to thank the Health Research Board in Ireland for providing the funding for this project. We would also like to thank the HSE-PCRS scheme for providing the data on which the study was based and Health Atlas Ireland for providing access to the HIPE data and DRG costs.
Conflicts of interest
- 1.Anonymous (1993) Consensus development conference: diagnosis, prophylaxis and treatment of osteoporosis. Am J Med 94:646–650Google Scholar
- 20.Interim Performance Monitoring Report May 2008. National Service Plan, http://www.hse.ie/eng/services/Publications/corporate/performancereports/May_2008_Performance_Monitoring_Report.pdf Accessed 13 Jun 2011
- 21.The Diagnosis Related Groups (DRGs) to adjust payment mechanisms for health system providers. www.ciss.org.mx/pdf/en/studies/CISS-WP-05122.pdf. Accessed 13 Jun 2011
- 25.Schnitzer T, Bone HG, Crepaldi G et al (2000) Therapeutic equivalence of alendronate 70 mg once-weekly and alendronate 10 mg daily in the treatment of osteoporosis. Alendronate Once-Weekly Study Group. Aging (Milano) 12:1–12Google Scholar
- 30.Boonen S, Adachi JD, Man Z, Cummings SR, Lippuner K, Törring O, Gallagher JC, Farrerons J, Wang A, Franchimont N, San Martin J, Grauer A, McClung M (2011) Treatment with denosumab reduces the incidence of new vertebral and hip fractures in postmenopausal women at high risk. J Clin Endocrinol Metab 96(6):1727–1736PubMedCrossRefGoogle Scholar
- 32.McGowan B, Bennett K (2012) Adherence with antiosteoporosis medications: a primary–care study. Prescriber, 34–37Google Scholar
- 35.Population Ageing in Ireland. Projections 2002–2021 (http://www.nuim.ie/staff/dpringle/ncaop-report.pdf) Accessed 10 Jun 2011
- 36.Statistics/Health in Ireland: Key Trends, 2010/Population and Life Expectancy www.dohc.ie/statistics/key…and_life_expectancy/figure_1-3.html Accessed 10 Jun 2011
- 40.Harris ST, Watts NB, Genant HK, McKeever CD, Hangartner T, Keller M et al (1999) Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. Vertebral Efficacy with Risedronate Therapy (VERT) Study Group. JAMA 282:1344–1352PubMedCrossRefGoogle Scholar
- 41.Reginster JY, Felsenberg D, Boonen S, Diez-Perez A, Rizzoli R, Brandi ML, Spector TD, Brixen K, Goemaere S, Cormier C, Balogh A, Delmas PD, Meunier PJ (2008) Effects of long-term strontium ranelate treatment on the risk of nonvertebral and vertebral fractures in postmenopausal osteoporosis: results of a five-year randomized, placebo-controlled trial. Arthris Rheum 58(6):1687–1695CrossRefGoogle Scholar
- 43.Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, Delmas P, Zoog HB, Austin M, Wang A, Kutilek S, Adami S, Zanchetta J, Libanati C, Siddhanti S, Christiansen C, Freedom Trial (2009) Denosumab for the prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med 351(8):756–765CrossRefGoogle Scholar
- 45.Report of the National Steering Group on the Prevention of Falls in Older People and the Prevention and Management of Osteoporosis throughout Life. Strategy to Prevent Falls and Fractures in Ireland’s Ageing Population. 2008 January. www.hse.ie/…/Older/Strategy_to_Prevent_Falls_and_Fractures_in_Ireland’s_Ageing_Population_-_Full_report.pdf