As policymakers look to reduce healthcare costs, they might look closely at ways to prevent osteoporosis, the culprit that led to 1 million hospitalizations in 2006, 254,000 of which were because of fractures stemming from the gradual loss of bone, according to a new report released by the federal Agency for Health Research and Quality.
Using statistics from a nationally representative sample of hospital inpatient stays, the Agency for Health Research and Quality found that not only did these patients generate $2.4 billion in costs in 2006, they required longer hospital stays and two-thirds were admitted through the emergency department.
And more than half the patients were more likely to be discharged to a long-term nursing home or rehabilitation center, compared to 16% of all patients requiring hospitalization for any reason. Fractures can be slow to heal, cause debilitating pain, disability, deformities, and, sometimes, death.
Because most such patients are at least age 65, Medicare paid 87.4% of the bill, according to the report.
"An estimated 10 million people in the U.S. had osteoporosis in 2006," wrote Allison Russo, Laurel Holmquist, and Anne Elixhauser from the AHRQ.
"Despite its prevalence and impact, osteoporosis is both a preventable and treatable condition. Vitamin D, a diet high in calcium, regular exercise and access to bone mineral density screenings and medical treatment can prevent, improve and slow the progression of the condition," they wrote.
However, they continued, "barriers to care, such as variations and limitations in provider coverage of screening tests, could inhibit early detection and treatment, creating a substantial strain on the U.S. healthcare system as the population ages."
A chart accompanying their report shows the steady rise in the rate of hospitalizations where osteoporosis was coupled with an injury. In 1995, there were 55 stays per 100,000 people; in 1999, there were 70; in 2004, 81; and in 2006, 85.
Pathological fractures were the most common osteoporotic injury, followed by hip fractures, fractures of the vertebrae, ribs and pelvis, superficial injuries and contusions, and lastly leg and arm fractures.
Females in all age brackets are affected more than males. Over age 65, five times more women were hospitalized with injurious osteoporosis than men.
One apparent mystery, however, is the wide variation in what part of the country these hospitalizations occur. The Midwest had the highest rate, with 107 per 100,000 people, followed by the Northeast, with 87. Rates in the South and West were considerably lower, with 81 and 68 stays per 100,000 people.
Why people in the Midwest were so disproportionately affected is unclear.
In terms of cost, hip fractures were the most expensive, costing an average of $12,100 each, and required the longest hospital stays (5.7 days).