우리나라 노인여성의 골다공증성 척추골절로 인한 경제적 부담 추계
Estimating the Economic Burden of Osteoporotic Vertebral Fracture among Elderly Korean Women
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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 W 50 years old with a diagnosis of VF. The first 6-months was defined as a Xclearance 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 W 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.
Abstract
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 W 50 years old with a diagnosis of VF. The first 6-months was defined as a Xclearance 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 W 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.
참고문헌 (29)
- Ben Sedrine W, "On conducting burden-of-osteoporosis studies: A review of the core concepts and practical issues. A study carried out under the auspices of a WHO Collaborating Center", Rheumatology, 40(1), pp.7~14 (2001)
- World Health Organizaion, "Assessment of Fracture Risk and Its Application to Screening for Postmenopausal Osteoporosis. WHO Technical Report Series, No. 843" (1994), World Health Organizaion
- Max W, "The burden of osteoporosis in California, 1998", Osteoporos Int, 13(6), pp.493~500 (2002)
- Finnern HW, "The hospital cost of vertebral fractures in the EU: Estimates using national datasets", Osteoporos Int, 14(5), pp.429~436 (2003)
- Nevitt MC, "The association of radiographically detected vertebral fractures with back pain and function: a prospective study", Ann Intern Med, 128(10), pp.793~800 (1998)
- Ismail AA, "Prevalent vertebral deformity predicts incident hip though not distal forearm fracture: Results from the European Prospective Osteoporosis Study", Osteoporos Int, 12(2), pp.85~90 (2001)
- Lindsay R, "Risk of new vertebral fracture in the year following a fracture", JAMA, 285(3), pp.320~323 (2001)
- Black DM, "Prevalent vertebral deformities predict hip fractures and new vertebral deformities but not wrist fractures", J Bone Miner Res, 14(5), pp.821~828 (1999)
- Ross PD, "Predicting vertebral fracture incidence from prevalent fractures and bone density among non-black, osteoporotic women", Osteoporos Int, 3(3), pp.120~126 (1993)
- Cauley JA, "Risk of mortality following clinical fractures", Osteoporos Int, 11(7), pp.556~561 (2000)
- Genant HK, "Interim report and recommendations of the World Health Organization Task-Force for Osteoporosis", Osteoporos Int, 10(4), pp.259~264 (1999)
- Gold DT, "The clinical impact of vertebral fractures: Quality of life in women with osteoporosis", Bone, 18(3), pp.185~189 (1996)
- Johnell O, "The hospital burden of vertebral fracture in Europe: A study of national register sources", Osteoporos Int, 7(2), pp.138~144 (1997)
- Delmas PD, "European Union challenges member states to fight the Xsilent epidemicYof osteoporosis", Eurohealth, 4(4), pp.1~4 (1998)
- Burge R, "Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025", J Bone Miner Res, 22(3), pp.465~475 (2007)
- Haentjens P, "Costs and consequences of hip fracture occurrence in old age: An economic perspective", Disabil Rehabil, 27(18-19), pp.1129~1141 (2005)
- Maravic M, "Incidence and cost of osteoporotic fractures in France during 2001. A methodological approach by the national hospital database", Osteoporos Int, 16(12), pp.1475~1480 (2005)
- Bouee S, "Estimation of direct unit costs associated with non-vertebral osteoporotic fractures in five European countries", Rheumatol Int, 26(12), pp.1063~1072 (2006)
- Gurkan I, "Epidemiology and financial burden of hip fractures", Curr Opin Orthop, 15(1), pp.8~11 (2004)
- Kanis JA, "Cost-effectiveness of preventing hip fracture in the general female population", Osteoporos Int, 12(5), pp.356~361 (2001)
- Wiktorowicz ME, "Papadimitropoulos E. Economic implications of hip fracture: Health service use, institutional care and cost in Canada", Osteoporos Int, 12(4), pp.271~278 (2001)
- Burge R, "Inpatient hospital and post-acute care for vertebral fractures in women", Value Health, 5(4), pp.301~311 (2002)
- Ekman M, "The economic cost of low back pain in Sweden in 2001", Acta Orthop, 76(2), pp.275~284 (2005)
- Drummond MF, "Methods for the Economic Evaluation of Health Care Programmes" (2005), Oxford University Press
- Korean Ministry of Labor, "2004 General Statistic Report of Wages" (2005), Korean Ministry of Labor
- Health Insurance Review and Assessment Service; National Health Insurance Corporation, "2004 Annual Statistic Report of National Health Insurance", Health Insurance Review and Assessment Service (2005)
- Lindsay R, "One year outcomes and costs following a vertebral fracture", Osteoporos Int, 16(1), pp.78~85 (2005)
- Barrett-Connor E, "The economic and human costs of osteoporotic fracture", Am J Med, 98(2a), pp.3~8 (1995)
- Hong MR, "A Survey of Status and Care Need of Elderly for Long Term Care" (2004), Healthcare Symposium
