Epidemiology of osteoporosis in Latin America 2008: [review] / Epidemiología de la osteoporosis en Latino América: [revisión]

Osteoporosis is a growing disease in Latin America, rates of fractures actually in LA are quite similar to the ones in Southern Europe and slightly lower than USA and Northern Europe. According to the population projection of the WHO subjects over 65 of age will increase significantly in the next 50 years in LA and the number of hip fractures in this area will equal the numbers in Europe and USA. Unfortunately, in LA there are not adequate resources in terms of medical facilities for osteoporosis diagnosis, treatment or rehabilitation. Moreover, there are no policies of reimbursement for osteoporosis densitometry, bone markers measurements or medications in many countries or it is very limited in the ones who have started some kind of specific program for this matters. Thus, we have to face this public health problem by increasing the awareness of the disease in the general population, specific risk groups, schools, journalists or politicians. Improve medical education at different levels: Medical students, General Practitioners, Specialists, Nurses, and Social Workers. And, we have to develop enough influence to Public and Private Health Systems in order to make them to develop specific osteoporosis programs to cover a wide range of the population in LA, who actually is absolutely abandon of this kind of support.

La osteoporosis es una enfermedad que se vuelve cada vez más frecuente en América Latina. Su prevalencia es muy parecida a la encontrada en Europa del Sur y ligeramente más baja que en Europa del Norte y en la población blanca de los EUA. De acuerdo a las proyecciones de población de la OMS, el número de fracturas que se registrarán en la región de Latino América en los próximos 50 años casi igualará los números encontrados en EUA y Europa. Desafortunadamente en Latino América no hay recursos médicos suficientes para el diagnóstico, tratamiento y rehabilitación de la osteoporosis. En muchos países no existen leyes (o son muy limitadas) que garanticen el pago de los estudios de densitometría ósea, las medidas de prevención o los medicamentos para tratarla. Actualmente, es posible enfrentar este problema de salud pública generando conciencia de la enfermedad en el pú­blico general, en los grupos de riesgo y en las escuelas, con el apoyo de periodistas y sensibilizando a los políticos. También se debe mejorar la educación médica a nivel de las escuelas de medicina, entre los médicos generales, los especialistas, las enfermeras y los trabajadores sociales; se debe lograr suficiente influencia en el sistema de salud pública y privada para hacer que se desarrollen programas específicos contra la osteoporosis, que cubran al amplio rango de población Latinoamericana que actualmente no tiene ninguna clase de apoyo.

Estimating the Economic Burden of Osteoporotic Vertebral Fracture among Elderly Korean Women / 예방의학회지

OBJECTIVES: To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. METHODS: From 2002 to 2004, we identified all National Health Insurance claims records for women > or = 50 years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," Ysuch that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with > or = one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. RESULTS: During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. CONCLUSIONS: Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.