Healthcare costs associated with opportunistically identifiable vertebral fractures
Healthcare costs associated with opportunistically identifiable vertebral fractures
Purpose: vertebral fractures (VFs) are often available on radiological imaging undertaken during daily clinical work, yet the healthcare cost burden of these opportunistically identifiable fractures has not previously been reported. In this study, we examine the direct healthcare costs of subjects with vertebral fractures available for identification on routine CT scans.
Methods: thoracolumbar vertebral fractures were identified from 2000 routine CT scans. Subjects with VF on the scan were matched 1:2 against subjects with no VF on the scan, and similarly in a 1:3-ratio against a general population cohort. We excluded those subjects who received treatment with osteoporosis medication(s) in the year prior to baseline. Direct healthcare costs, identified from the national Danish registers, were accrued over up to 6 years of follow-up, and reported per day at risk and per year.
Results: in subjects undergoing a CT scan, costs were initially high, yet declined over time. Comparing subjects with prevalent vertebral fracture (n = 321) against those subjects with no vertebral fracture (n = 606), mean total healthcare costs per day at risk was numerically higher in the first three years after baseline, while healthcare costs per year were similar between the cohorts. No differences reached statistical significance. When compared to the general population cohort, costs were significantly higher in the vertebral fracture cohort.
Conclusions: subjects with vertebral fractures available for identification on routine CT scans incur substantially higher healthcare costs than matched subjects representing the general population, and numerically, albeit non-significantly, higher healthcare costs per day at risk in the short term, as compared to subjects with no visible VF on the CT scan.
Bone Density, Health Care Costs, Humans, Osteoporosis/complications, Osteoporotic Fractures/diagnostic imaging, Spinal Fractures/diagnostic imaging, Osteoporosis, Costs, Vertebral fracture, Epidemiology, Public health
Skjødt, Michael Kriegbaum
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Nicolaes, Joeri
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Smith, Christopher Dyer
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Libanati, Cesar
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Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Olsen, Kim Rose
1deb0114-5177-434e-859d-4729f1845e06
Abrahamsen, Bo
ea627e06-482e-479f-8631-5b0f3aec5d13
3 August 2023
Skjødt, Michael Kriegbaum
9e1b6d51-3b42-4938-a2c3-31b488704416
Nicolaes, Joeri
53748c31-2c0f-4eee-b315-cb720403f42c
Smith, Christopher Dyer
dba6c924-9083-4525-9e8a-30c05f609e69
Libanati, Cesar
4e3b711d-453b-4f15-b175-3975d566b9c9
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Olsen, Kim Rose
1deb0114-5177-434e-859d-4729f1845e06
Abrahamsen, Bo
ea627e06-482e-479f-8631-5b0f3aec5d13
Skjødt, Michael Kriegbaum, Nicolaes, Joeri, Smith, Christopher Dyer, Libanati, Cesar, Cooper, Cyrus, Olsen, Kim Rose and Abrahamsen, Bo
(2023)
Healthcare costs associated with opportunistically identifiable vertebral fractures.
Bone, 175, [116831].
(doi:10.1016/j.bone.2023.116831).
Abstract
Purpose: vertebral fractures (VFs) are often available on radiological imaging undertaken during daily clinical work, yet the healthcare cost burden of these opportunistically identifiable fractures has not previously been reported. In this study, we examine the direct healthcare costs of subjects with vertebral fractures available for identification on routine CT scans.
Methods: thoracolumbar vertebral fractures were identified from 2000 routine CT scans. Subjects with VF on the scan were matched 1:2 against subjects with no VF on the scan, and similarly in a 1:3-ratio against a general population cohort. We excluded those subjects who received treatment with osteoporosis medication(s) in the year prior to baseline. Direct healthcare costs, identified from the national Danish registers, were accrued over up to 6 years of follow-up, and reported per day at risk and per year.
Results: in subjects undergoing a CT scan, costs were initially high, yet declined over time. Comparing subjects with prevalent vertebral fracture (n = 321) against those subjects with no vertebral fracture (n = 606), mean total healthcare costs per day at risk was numerically higher in the first three years after baseline, while healthcare costs per year were similar between the cohorts. No differences reached statistical significance. When compared to the general population cohort, costs were significantly higher in the vertebral fracture cohort.
Conclusions: subjects with vertebral fractures available for identification on routine CT scans incur substantially higher healthcare costs than matched subjects representing the general population, and numerically, albeit non-significantly, higher healthcare costs per day at risk in the short term, as compared to subjects with no visible VF on the CT scan.
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Accepted/In Press date: 17 June 2023
e-pub ahead of print date: 22 June 2023
Published date: 3 August 2023
Additional Information:
Funding Information:
This is an investigator initiated study funded by a grant from the Region Zealand Health Scientific Research Foundation and by a collaborator grant from UCB Pharma/Amgen Inc. The lead author was supported by a PhD scholarship from the Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark. CL and JN are UCB Pharma employees, and the manuscript was shared with UCB Pharma/Amgen Inc. for courtesy review prior to submission. The other funders were not involved in the study.
Publisher Copyright:
© 2023 Elsevier Inc.
Keywords:
Bone Density, Health Care Costs, Humans, Osteoporosis/complications, Osteoporotic Fractures/diagnostic imaging, Spinal Fractures/diagnostic imaging, Osteoporosis, Costs, Vertebral fracture, Epidemiology, Public health
Identifiers
Local EPrints ID: 482478
URI: http://eprints.soton.ac.uk/id/eprint/482478
ISSN: 8756-3282
PURE UUID: 5ae6e437-06ec-4896-a04b-c16a733b628d
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Date deposited: 09 Oct 2023 16:39
Last modified: 18 Mar 2024 02:47
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Contributors
Author:
Michael Kriegbaum Skjødt
Author:
Joeri Nicolaes
Author:
Christopher Dyer Smith
Author:
Cesar Libanati
Author:
Kim Rose Olsen
Author:
Bo Abrahamsen
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