Expected lifetime numbers and costs of fractures in postmenopausal women with and without osteoporosis in Germany: a discrete event simulation model
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Expected lifetime numbers and costs of fractures in postmenopausal women with and without osteoporosis in Germany: a discrete event simulation model. / Bleibler, Florian; Rapp, Kilian; Jaensch, Andrea; Becker, Clemens; König, Hans-Helmut.
In: BMC HEALTH SERV RES, Vol. 14, No. 284, 01.01.2014.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Expected lifetime numbers and costs of fractures in postmenopausal women with and without osteoporosis in Germany: a discrete event simulation model
AU - Bleibler, Florian
AU - Rapp, Kilian
AU - Jaensch, Andrea
AU - Becker, Clemens
AU - König, Hans-Helmut
PY - 2014/1/1
Y1 - 2014/1/1
N2 - BACKGROUND: Osteoporotic fractures cause a large health burden and substantial costs. This study estimated the expected fracture numbers and costs for the remaining lifetime of postmenopausal women in Germany.METHODS: A discrete event simulation (DES) model which tracks changes in fracture risk due to osteoporosis, a previous fracture or institutionalization in a nursing home was developed. Expected lifetime fracture numbers and costs per capita were estimated for postmenopausal women (aged 50 and older) at average osteoporosis risk (AOR) and for those never suffering from osteoporosis. Direct and indirect costs were modeled. Deterministic univariate and probabilistic sensitivity analyses were conducted.RESULTS: The expected fracture numbers over the remaining lifetime of a 50 year old woman with AOR for each fracture type (% attributable to osteoporosis) were: hip 0.282 (57.9%), wrist 0.229 (18.2%), clinical vertebral 0.206 (39.2%), humerus 0.147 (43.5%), pelvis 0.105 (47.5%), and other femur 0.033 (52.1%). Expected discounted fracture lifetime costs (excess cost attributable to osteoporosis) per 50 year old woman with AOR amounted to € 4,479 (€ 1,995). Most costs were accrued in the hospital € 1,743 (€ 751) and long-term care sectors € 1,210 (€ 620). Univariate sensitivity analysis resulted in percentage changes between -48.4% (if fracture rates decreased by 2% per year) and +83.5% (if fracture rates increased by 2% per year) compared to base case excess costs. Costs for women with osteoporosis were about 3.3 times of those never getting osteoporosis (€ 7,463 vs. € 2,247), and were markedly increased for women with a previous fracture.CONCLUSION: The results of this study indicate that osteoporosis causes a substantial share of fracture costs in postmenopausal women, which strongly increase with age and previous fractures.
AB - BACKGROUND: Osteoporotic fractures cause a large health burden and substantial costs. This study estimated the expected fracture numbers and costs for the remaining lifetime of postmenopausal women in Germany.METHODS: A discrete event simulation (DES) model which tracks changes in fracture risk due to osteoporosis, a previous fracture or institutionalization in a nursing home was developed. Expected lifetime fracture numbers and costs per capita were estimated for postmenopausal women (aged 50 and older) at average osteoporosis risk (AOR) and for those never suffering from osteoporosis. Direct and indirect costs were modeled. Deterministic univariate and probabilistic sensitivity analyses were conducted.RESULTS: The expected fracture numbers over the remaining lifetime of a 50 year old woman with AOR for each fracture type (% attributable to osteoporosis) were: hip 0.282 (57.9%), wrist 0.229 (18.2%), clinical vertebral 0.206 (39.2%), humerus 0.147 (43.5%), pelvis 0.105 (47.5%), and other femur 0.033 (52.1%). Expected discounted fracture lifetime costs (excess cost attributable to osteoporosis) per 50 year old woman with AOR amounted to € 4,479 (€ 1,995). Most costs were accrued in the hospital € 1,743 (€ 751) and long-term care sectors € 1,210 (€ 620). Univariate sensitivity analysis resulted in percentage changes between -48.4% (if fracture rates decreased by 2% per year) and +83.5% (if fracture rates increased by 2% per year) compared to base case excess costs. Costs for women with osteoporosis were about 3.3 times of those never getting osteoporosis (€ 7,463 vs. € 2,247), and were markedly increased for women with a previous fracture.CONCLUSION: The results of this study indicate that osteoporosis causes a substantial share of fracture costs in postmenopausal women, which strongly increase with age and previous fractures.
KW - Aged
KW - Cost of Illness
KW - Female
KW - Fractures, Bone
KW - Germany
KW - Humans
KW - Middle Aged
KW - Osteoporosis, Postmenopausal
KW - Probability
KW - Risk Factors
U2 - 10.1186/1472-6963-14-284
DO - 10.1186/1472-6963-14-284
M3 - SCORING: Journal article
C2 - 24981316
VL - 14
JO - BMC HEALTH SERV RES
JF - BMC HEALTH SERV RES
SN - 1472-6963
IS - 284
ER -