Coste de la fractura de cadera osteoporótica en España por comunidad autónoma

espanolObjetivo Se estimo la utilizacion de recursos sanitarios (URS) y costes asociados durante los 12meses posteriores a una primera fractura de cadera osteoporotica (FCO) por comunidad autonoma (CC.AA.). Metodos Estudio observacional, prospectivo, que incluyo pacientes ≥65anos hospitalizados por una primera FCO en Andalucia, Cataluna, Comunidad Valenciana, Galicia, Madrid y Pais Vasco. Se registro la URS relacionada con la FCO, la calidad de vida y la autonomia del paciente, y se estimaron los costes asociados. Resultados Participaron 487 pacientes (edad media: 83,1anos, 77% mujeres), con caracteristicas demograficas similares entre CC.AA. La duracion media del ingreso fue mas prolongada en Madrid y en Galicia (mujeres/hombres: 15,0/18,6 y 16,9/12,6 dias) y menor en Andalucia y en la Comunidad Valenciana (8,2/7,2 y 8,4/9,4dias). Las sesiones de rehabilitacion y dias de asistencia domiciliaria formal fueron mas numerosos en Cataluna y en Madrid (mujeres/hombres: 16/21 y 17/29 sesiones; 19/20 y 30/27dias) comparado con Andalucia y Galicia (4/1 y 3/0 sesiones; 3/1 y 1/0dias). Los costes medios fueron mas altos en Madrid y menores en Andalucia (mujeres/hombres: 12.321/12.297€ y 7.031/6.115€, respectivamente). Conclusiones Las FCO implican un coste elevado para los sistemas sanitarios autonomicos, observandose diferencias notables entre CC.AA., derivadas principalmente de la duracion diferencial de la primera estancia hospitalaria, asi como al cuidado ambulatorio durante los meses posteriores. Estas diferencias podrian estar relacionadas con diferencias en la demora quirurgica. Es deseable un abordaje y consenso a nivel nacional de este problema sanitario, con pautas de actuacion comunes, ya que podria suponer grandes beneficios socioeconomicos y sanitarios globales. EnglishObjective We estimated the health resource utilization (HRU) and associated costs during the 12months after a first osteoporotic hip fracture (OHF) in six Spanish Regions. Methods Observational, prospective study including patients ≥65years-old hospitalized 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: 83.1years, 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 16.9/12.6days, respectively) and shortest in Andalusia and the Valencian Community (8.2/7.2 and 8.4/9.4days). 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 30/27days) and fewer in Andalusia and Galicia (4/1 and 3/0 sessions; 3/1 and 1/0days). Mean HRU costs were higher in Madrid and lower in Andalusia (women/men: 12,321€/12,297€ and 7,031€/6,115€, 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.