Cost of osteoporosis-related fractures in Brazilian Unified Health System

Abstract

Osteoporosis is a relevant public health problem. It is characterized by low bone mineral density associated with fragility fractures that generally involve the hip, vertebrae, forearm and wrist. Objective: The study aims to describe the costs of low-energy fractures resulting from simple falls, typical of the osteoporosis. Methods: We conducted a study of costs for procedures performed in the Brazilian hospitals and a descriptive study of the frequency of osteoporosis-related fractures in women’s, in 2009-2011. The costing methodology followed the Activity-Based Costing (ABC), with the perspective of hospital / surgical procedures of the Unified Health System related to osteoporosis. Results: It was observed that the highest costs were for vertebral fractures, followed by fractures of the hips, forearm and wrists. Costs of vertebral fractures ranged from R$ 18,299.31 to R$ 36,970.99; hip fractures from R$ 3,870.07 to R$ 20,042.60. Costs for forearm fractures ranged from R$ 2,467.26 to R$ 8,074.55. Costs of fractures wrists ranged from R$ 827.64 to R$ 7,043.29.Mostly the higher cost of the treatment was due to the purchase of protheses and human resources. Discussion: Although the higher costs are related to vertebral fractures, the most relevant clinical outcomes of osteoporosis are fractures of hips, due to its high incidence. Conclusion: Higher costs related to osteopo[1]rotic fractures impact not only on the health system budget, but also in the quality of life of individuals due to the high morbidity and mortality. Investments for educational guidance with fall prevention should be prioritized, as well as early diagnosis and treatment of osteoporosis.