Cost of osteoporotic hip fracture in Spain per Autonomous Region

Abstract Objective We estimated the health resource utilisation (HRU) and associated costs during the 12 months after a first osteoporotic hip fracture in Spain per Autonomous Regions (OHF) in six Spanish Regions. Methods Observational, prospective study including patients ≥65 years-old hospitalised due to a first OHF in: Andalusia, Catalonia, Valencian Community, Galicia, Madrid and the Basque Country. HRU related to OHF, quality of life and patient autonomy were collected, and HRU-associated costs were estimated. Results Four hundred and eighty-seven patients (mean age: 83.1 years, 77% women) were included, with demographic characteristics that were similar across the Regions. Mean hospital stay was longest in Madrid and Galicia (women/men: 15.0/18.6 and 16.9/12.6 days, respectively) and shortest in Andalusia and the Valencian Community (8.2/7.2 and 8.4/9.4 days). There were more rehabilitation sessions and formal home care days in Catalonia and Madrid (women/men: 16/21 and 17/29 sessions; 19/20 and 30/27 days) and fewer in Andalusia and Galicia (4/1 and 3/0 sessions; 3/1 and 1/0 days). Mean HRU costs were higher in Madrid and lower in Andalusia (women/men: 12.321€/12,297€ and 7031€/6115€, respectively). Conclusions OHF place a large burden on Spanish Regional Health Systems, including high economic costs. We found notable differences in mean costs across the Regions, mainly caused by the differential length of the first hospital stay and the outpatient care in subsequent months. These differences may be associated with differences in surgical delay. A national consensus on the management of OHF is desirable; moreover, agreeing common guidelines could have major socio-economic and healthcare benefits.