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A 12-Year Ecological Study of Hip Fracture Rates among Older Taiwanese Adults

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Abstract

Hip fracture rates in Taiwan are among the highest in the world. The aim of this study was to describe the trends of hip fracture hospitalizations among Taiwanese elderly (aged ≥ 65 years) and the trends of antiosteoporosis medication expenditure from 1999 to 2010. We conducted an ecological study using inpatient health care-utilization data from the Department of Health, and medication expenditure data from the IMS Health, Taiwan. The International Classification of Disease, Clinical Modification, 9th version, code 820 was used to identify hip fracture hospitalizations. Medications included alendronate, calcitonin, ibandronate, raloxifene, strontium ranelate, teriparatide, and zoledronic acid. Year 2010 was assigned as the reference point for age-standardized rates, currency exchange (to the US dollar), and discount rates. Over the 12-year study period, age-standardized hip fracture hospitalizations decreased by 2.7 % annually (p for trend < 0.001) for Taiwanese elders. The decline was more obvious among those aged ≥75 years (6.1 %). However, the number of hip fracture hospitalizations increased from 14,342 to 18,023. Total hospitalization costs increased by US$0.6 ± 0.2 million annually (p for trend = 0.002); however, the per capita costs decreased by US$23.0 ± 8.0 (p for trend = 0.017). The total medication expenditure increased 7.2-fold, from US$8.1 million to US$58.9 million, accounting for an increase in the overall pharmaceutical market by fivefold, from 3.4 to 15.9 ‰ (both p for trend < 0.001). From 1999 to 2010, there was a decline in hip fracture rates among elderly Taiwanese adults with a concomitant increase in antiosteoporosis medication expenditure.

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Acknowledgements

The authors thank Novartis, Taiwan, for initiation of the study concept and MSD, Taiwan, for obtaining the IMS data. We also thank the secretary of the TOA for coordinating the study.

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Authors and Affiliations

  1. Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7 Chung Shan S. Rd., Taipei, 100, Taiwan

    Ding-Cheng Chan, Yow-Shan Lee & Cheng-Ting Chen

  2. Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung Shan S. Rd., Taipei, 100, Taiwan

    Ding-Cheng Chan & Keh-Sung Tsai

  3. Department of Family Medicine, National Taiwan University Hospital, No. 7 Chung Shan S. Rd., Taipei, 100, Taiwan

    Yow-Shan Lee

  4. Department of General Internal Medicine, Buddhist Tzu chi General Hospital, No. 707, Sec. 3, Chung Yang Rd., Hualien, 970, Taiwan

    Ya-Ju Wu

  5. Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, 350, Taiwan

    Hsiao-Hui Tsou

  6. Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, No. 5, Fusing St., Taoyuan County, 333, Taiwan

    Jawl-Shan Hwang

  7. Department of Laboratory Medicine, National Taiwan University Hospital, No. 7 Chung Shan S. Rd., Taipei, 100, Taiwan

    Keh-Sung Tsai

  8. Bei-Hu Branch, National Taiwan University Hospital, No. 87, Neijiang St., Taipei, 108, Taiwan

    Keh-Sung Tsai

  9. Department of Orthopedics, National Taiwan University Hospital, Research Building 11-17, No. 7 Chung Shan S. Rd., Taipei, 100, Taiwan

    Rong-Sen Yang

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  1. Ding-Cheng Chan
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Correspondence to Rong-Sen Yang.

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Chan, DC., Lee, YS., Wu, YJ. et al. A 12-Year Ecological Study of Hip Fracture Rates among Older Taiwanese Adults. Calcif Tissue Int 93, 397–404 (2013). https://doi.org/10.1007/s00223-013-9759-x

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  • DOI: https://doi.org/10.1007/s00223-013-9759-x

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