Economic burden of osteoporosis in women: data from the 2008 French hospital database (PMSI).

OBJECTIVES: To estimate the number and costs of hospitalisations associated with osteoporosis in France. METHODS: Data for women aged 50 years and over were extracted from the 2008 French Hospital National Database. Criteria for acute care were established according to ICD-10 codes related to osteoporosis. As coding rules are not systematically used, an additional extraction which included surgical stays for hip fractures was performed in order to be more exhaustive. The two datasets were merged and duplicate stays excluded. Among women hospitalised in acute care during 2008, we selected those progressing to rehabilitation care within the year. We assessed the numbers of hospitalisations and women, proportion of surgical management, length of stay in acute care and numbers of rehabilitation days and costs. Hospital costs were calculated according to the National Hospital Tariff and National Scale of Costs, respectively, for acute and rehabilitation care based on 2009 tariffs. RESULTS: There were 67.807 hospitalisations (64.793 patients) associated with osteoporosis; 83% of total hospitalisations were in patients aged ≥75 years. A total of 80% of hospitalisations were associated with surgical management of fractures and 31.458 patients (49%) progressed from hospitalisation to rehabilitation. The mean ±SD length of stay was 12±8 days for hospitalisation and 43±31 days for rehabilitation care. The overall cost of hospitalisations was €415.4 million, of which 4.2% was related to medical devices. The overall cost of rehabilitation was €331.8 million. CONCLUSIONS: In 2008, postmenopausal osteoporosis was associated with a substantial economic burden at hospital in France.

Epidemiology of osteoporosis-related fractures in France: a literature review.

OBJECTIVES: To evaluate the health implications and economic burden on society of osteoporotic fractures as a major source of morbidity and mortality in the ageing population. METHODS: We have summarised the findings of a literature review of French studies published between 1960 and 2009, characterised the epidemiology of osteoporosis and osteoporotic fractures, and predicted future trends. RESULTS: Published data for France supported the observation that osteoporosis is under-diagnosed in many countries. The incidence of fracture increased exponentially with age, alongside a concurrent decrease in bone mineral density, a risk factor for fracture. Combined with a projected rise in the French elderly population, this poses a significant burden for the future. The incidence of fracture was high in the osteopenic population; consequently, fragility fractures may be underestimated if reports focus on osteoporotic women only. As in many other countries, French data revealed that women have a higher incidence of osteoporotic fractures than men, although mortality from hip fracture was higher in men. DISCUSSION: Due to ageing of the population, an increase in the number of people suffering from fractures is predicted over the next few decades unless preventative action is taken, highlighting the need for improved diagnosis and screening in postmenopausal women.