Inpatient cost of treating osteoporotic fractures in mainland China: a descriptive analysis

Abstract

Yicheng Yang,1 Fen Du,2 Wenyu Ye,3 Yu Chen,4 Jinghu Li,5 Jie Zhang,6 Helen Nicely,7 Russel Burge8 1Patient Outcomes and Real World Evidence, Lilly Suzhou Pharmaceutical Co, Ltd, Shanghai, 2Pharmacoeconomics and Outcomes Research, Beijing Brainpower Pharma Consulting Co, Ltd, Beijing, People's Republic of China; 3Real World Analytics Bio-Medicines, Eli Lilly and Company, Indianapolis, IN, USA; 4Medical Department, Lilly Suzhou Pharmaceutical Co, Ltd, Shanghai, 5Secretariate, 6Technology Standard Department, China Health Insurance Research Association, Beijing, People's Republic of China; 7Medical Writing, inVentiv Health Clinical, San Francisco, CA, 8Global Patient Outcomes and Real World Evidence, Bio-Medicines, Eli Lilly and Company, Indianapolis, IN, USA Purpose: The objective of this study was to provide new estimates on the per-admission inpatient hospital cost and per-admission length of stay (LOS) for osteoporosis-related fractures in mainland China. Materials and methods: Data for inpatient hospitalization associated with at least one osteoporosis-related fracture were obtained from the nationwide China Health Insurance Research Association and were analyzed post hoc. Patients' data were included if the patients were ≥50 years old and diagnosed with osteoporosis and pathologic fracture, or osteoporosis therapy and fragility fracture by an International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) code designation, between 2008 and 2010. Results: The analysis included 830 patients (female: 77.3%; mean age: 73.4±9.8 years). The medians of the per-admission LOS and inpatient costs were 19 days and ¥18,587, respectively. Longer LOS and higher costs per admission were associated with older patients (≥70 years) compared to younger patients (<70 years). Hip fracture had the longest median LOS (22 days) and highest median cost (¥32,594) among all fracture sites. The per-hospitalization episode and per-day costs of osteoporotic fracture increased rapidly (60% and 89%, respectively) between 2008 and 2010. Conclusion: The analysis showed that hospitalization cost increases were associated with increasing per-day hospitalization costs. The proportion of the costs reimbursed by health insurances increased, while the mean absolute patient copayment amounts decreased. The incidence and prevalence of osteoporosis and osteoporosis-related fractures may rise rapidly due to the projected growth of the aged population in mainland China. Therefore, the combination of greater anticipated total fractures and rising hospital costs may lead to a tremendously increased economic burden in the future. Keywords: inpatients, hospital costs, length of stay, osteoporosis burden, mainland China