The health and economic consequences of osteopenia- and osteoporosis-attributable hip fractures in Germany: estimation for 2002 and projection until 2050.

SUMMARY: The health and economic burden of osteopenia- and osteoporosis-attributable hip fractures (OHF) in Germany was estimated for 2002 and projected until 2050. We found 108,341 OHF resulting in 2,998 million Euros cost, which will more than double by the year 2050, calling for improvement and development of prevention strategies for OHF.
INTRODUCTION: This study aimed to estimate the health impact and the societal costs of OHF in Germany in the year 2002 and to extrapolate these estimates to the years 2020 and 2050.
METHODS: We estimated OHF-attributable deaths, years of potential life lost (YPLL) and quality-adjusted life years lost (QALYs) using attributable fractions. Direct costs for acute treatment, rehabilitation, nursing care, non-medical costs and indirect costs for sickness absence, early retirement and mortality were estimated. All estimates were extrapolated to 2020 and 2050 using an estimation of future population composition and life expectancy.
RESULTS: We found 108,341 OHF resulting in 3,485 deaths, 22,724 YPLL, 114,058 QALYs, 2,736 millions of Euros direct cost and 262 millions of Euros indirect costs. Projection to 2020 showed corresponding increases of 44%, 62%, 56%, 49%, 47% and 33%, whereas the projection to 2050 resulted in changes of 128%, 215%, 196%, 152%, 138% and 90%, respectively.
CONCLUSIONS: OHF have considerable impact on health and direct costs in the elderly. Both may strongly increase in future decades due to demographic changes, calling for improvement and development of effective strategies for preventing and dealing with OHF.