Archives of Osteoporosis

, 13:37 | Cite as

Estimated expenditures for hip fractures using merged healthcare insurance data for individuals aged ≥ 75 years and long-term care insurance claims data in Japan

  • Takahiro Mori
  • Nanako Tamiya
  • Xueying Jin
  • Boyoung Jeon
  • Satoru Yoshie
  • Katsuya Iijima
  • Tatsuro Ishizaki
Original Article



Little is known about hip fracture expenditure in Japan. Using claims data obtained from a core city near Tokyo, we estimated the mean healthcare expenditure and monthly long-term care expenditure post-hip fracture to be ¥2,600,000 (US$29,500) and ¥113,000 (US$1290), respectively.


We aimed to estimate healthcare and long-term care expenditures post-hip fracture in Japan.


Healthcare insurance claims data for adults aged  75 years were merged with long-term care insurance claims data. We analyzed the data of hip fracture patients who were admitted to non-diagnosis procedure combination/per-diem payment system (DPC/PDPS) hospitals in a core city near Tokyo between April 2012 and September 2013. We estimated healthcare expenditure, namely, the difference between total payments 6 months pre- and 6 months post-hip fracture, and monthly long-term care expenditure for those who did not use long-term care insurance pre-hip fracture, but who commenced long-term care insurance post-hip fracture. We also performed multiple linear regressions to examine the associations of healthcare or long-term care expenditure with various factors.


The estimated mean healthcare (n = 78) and monthly long-term care (n = 42) expenditures post-hip fracture were ¥2,600,000 (US$29,500) and ¥113,000 (US$1290), respectively. In multiple linear regressions, healthcare expenditure was positively associated with longer duration of hospital stay (p = 0.036), and negatively associated with higher Charlson Comorbidity Index scores (p = 0.015). Monthly long-term care expenditure was positively associated with higher care-needs level post-hip fracture (p = 0.022), and usage of institutional care services (p < 0.001).


This is the first study to estimate healthcare and long-term care expenditures post-hip fracture using claims data in Japan. Further studies are needed that include healthcare claims data at both DPC/PDPS and non-DPC/PDPS hospitals to capture the lifelong course of long-term care required post-hip fracture.


Healthcare expenditure Long-term care expenditure Hip fracture Claims data Osteoporosis 



We thank Dr. Tetsuo Tsuji for obtaining healthcare and long-term care claims data from the local city government and thank Dr. Hideto Takahashi for providing statistical support. We also thank Editage ( for English language editing.

Author contributions

Takahiro Mori: conception and design, analysis and interpretation of data, drafting the article, revising the article critically for important intellectual content, final approval. Takahiro Mori had full access to all of the data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis.

Nanako Tamiya: conception and design, collection of data, revising the article critically for important intellectual content, final approval.

Xueying Jin: analysis and interpretation of data, revising the article critically for important intellectual content, final approval.

Boyoung Jeon: analysis and interpretation of data, revising the article critically for important intellectual content, final approval.

Satoru Yoshie: conception and design, collection of data, revising the article critically for important intellectual content, final approval.

Katsuya Iijima: conception and design, collection of data, revising the article critically for important intellectual content, final approval.

Tatsuro Ishizaki: conception and design, collection of data, revising the article critically for important intellectual content, final approval.

Funding information

This work was supported by Ministry of Health, Labour and Welfare (H27-seisaku-senyaku-012) and AMED (Japan Agency for Medical Research and Development) (17dk0110026h0001), and JSPS KAKENHI (17 K08899).

Compliance with ethical standards

The ethics committee of the University of Tsukuba approved this study (Approved number: 1075).

Conflicts of interest



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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  • Takahiro Mori
    • 1
    • 2
    • 3
  • Nanako Tamiya
    • 1
  • Xueying Jin
    • 1
  • Boyoung Jeon
    • 1
  • Satoru Yoshie
    • 4
  • Katsuya Iijima
    • 4
  • Tatsuro Ishizaki
    • 5
  1. 1.Research and Development Center for Health Services, Faculty of MedicineUniversity of TsukubaTsukubaJapan
  2. 2.Department of General Internal MedicineEastern Chiba Medical CenterToganeJapan
  3. 3.Department of General Medical Science, Graduate School of MedicineChiba UniversityChibaJapan
  4. 4.Institute of GerontologyUniversity of TokyoTokyoJapan
  5. 5.Human Care Research TeamTokyo Metropolitan Institute of GerontologyTokyoJapan

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