Health resource utilization of osteoporosis patients at Phramongkutklao Hospital

Abstract

Osteoporosis is a major burden of musculoskeletal disorders. Osteoporosis will become a major health problem due to the increasing life expectancy and elderly population. The purpose of this study was to assess health resource utilization in treatment of osteoporos is from a provider's perspective. Hospital utilization records were retrieved from Phramongkutklao Hospital electronic database during October 2002 - September 2003, fiscal year 2003. Patients with osteoporosis diagnoses or taking medicine for osteoporosis were included There were 2,302 osteoporosis patients , 435 had osteoporosis diagnosis. The mean age of all patients was 64.11 years. The mean age of in-patients, 63.63 years, was lower than 64.05 years of outpatients. Women were the majority of patients, at 83.01%. About 67% of osteoporosis patients had at least one chronic concomitant disease. Common chronic concomitant diseases were hypertension (26.67%), metabolic disorders (20.93%), osteoarthritis (12.38%), and diabetes mellitus (9.08%). Cost of osteoporotic patient was estimated from a cost to charge ratio. Total cost of osteoporotic patients was 83.11 million Baht or 4.93% of the total Phramongkutklao Hospital cost (1.68 billion Baht). Cost of osteoporosis and related osteoporosis fractures accounted for 43.99 million Baht or 53.93% of total osteoporosis treatment cost. Outpatient cost accounted for 52.81 million Baht or 63.54% of total osteoporosis cost. A major proportion of cost was for drugs, 85.02% of total outpatient cost. For osteoporosis outpatient the services, the average cost per person and per visit was 17,674.99 Baht and 4,148.33 Baht, respectively. In-patient cost accounted for 30.30 million Baht, only 2.39% was attributed to osteoporosis admission as the principal diagnosis, 12.60% was attributed to fracture related to osteoporosis. Hip fracture was the highest cost per admission with 67,891.49 Baht, whereas, diseases other than osteoporosis accounted for the highest cost pe