RESUMO
BACKGROUND: Italy is the Country with the highest life expectancy in the world, and over 75,000 elderly people experience a hip fracture each year. OBJECTIVE: following the Tuscany TARGET protocol, we aimed to estimate the costs of pharmacological treatment in the hypothesis of treating all elderly Italian people with hip fractures. METHODS: we analyzed the Tuscany healthcare system databases at the beginning of the Tuscany TARGET project for the prevention of hip fractures in elderly patients, and the Italian national hospitalizations records and DRGs databases concerning hip fractures occurred between 2000 and 2005. RESULTS: costs sustained for pharmacological treatments effective in reducing the risk of subsequent hip fractures all over Italy would account for 17.5 million Euros, representing only 0.18% of the overall national pharmaceuticals expenditures, while the national healthcare service is currently spending more than 30% of the overall pharmaceuticals expenditures in providing cardiovascular-active drugs. CONCLUSIONS: The burden of hip fractures in the Italian elderly population is substantial and must be acknowledged as an important health problem. Specific preventive strategies, such as the Tuscany TARGET project should be implemented in all Italian regions.
RESUMO
BACKGROUND: The official inquiry on osteoporosis in Italy, promoted by the Italian Senate in 2002 concluded that proper preventive strategies should be adopted at regional level in order to prevent osteoporotic fractures. Tuscany is the first Italian region who has promoted an official program (the TARGET project) aimed to reduce osteoporotic fractures by ensuring adequate treatment to all people aged ≥65 years old who experience a hip fragility fracture. OBJECTIVE: this paper provides information concerning the implementation of TARGET project in Tuscany, assuming that it may represent an useful model for similar experiences to be promoted in other Italian Regions and across Europe. METHODS: we have examined the model proposed for the regional program, and we have particularly analyzed the in-hospital and post-hospitalization path of hip fractured patients aged >65 years old in Tuscany after the adoption of TARGET project by Tuscany healthcare system and during its ongoing start-up phase. RESULTS: orthopaedic surgeons have been gradually involved in the project and are increasingly fulfilling all the clinical prescriptions and recommendations provided in the project protocol. Different forms of cooperation between orthopaedic surgeons and other clinical specialists have been adopted at each hospital for the treatment of hip fractured elderly patients. GPs involvement needs to be fostered both at regional and local level. CONCLUSIONS: The effort of Tuscany region to cope with hip fractures suffered from elderly people must be acknowledged as an interesting way of addressing this critical health problem. Specific preventive strategies modelled on the Tuscany TARGET project should be implemented in other Italian regions.
