The hospitalisation costs and out-patient costs of fragility fractures

Despite the high number of osteoporotic fractures sustained in the UK per annum there remains uncertainty in the cost associated with each fracture type, with literature estimates either conflicting, being non-existent or dated. With prescribing policies more frequently driven by health economic analyses errors in the estimated costs of fracture will lead to inefficient use of the healthcare budget. We present the estimated costs for each fracture type using a common methodology. UK data has been used wherever possible, however where this did not exist, or was inapplicable, data from Sweden was used as a proxy. Where both UK and Swedish data were available it was seen that in comparison costs are greater in the UK and thus our values are likely to be conservative. The average lengths of stay per fracture and cost per bed-day have been used to calculate the inpatient costs incurred by those admitted to hospital. Ratios of inpatient to out-patient costs from Sweden have been used to estimate the cost of out-patient care, which was also assumed equal to the costs incurred by patients with a clinical fracture where hospitalisation was not required. Whilst fractures at the hip, pelvis and other femoral sites incur the largest costs, it is seen that the costs of fractures at the tibia, fibula, spine, proximal humerus and humerus shaft are far from insignificant and should be included in all health-economic analyses of osteoporosis interventions.