Hospitalisation for osteoporosis

People with osteoporosis can be hospitalised for a range of reasons, including minimal trauma fractures. These fractures can occur from a minor bump, fall from a standing height or an event that would not normally result in a fracture if the bone was healthy. Minimal trauma fractures generate substantial costs to the community, including with direct costs in terms of hospital treatment.

Data from the AIHW National Hospital Morbidity Database (NHMD), show that in 2015–16 there were 7,700 hospitalisations with a principal diagnosis of osteoporosis for people aged 50 and over. The hospitalisation rate for people with osteoporosis was greatest for people aged 85 or over (486 per 100,000 population). After adjusting for age, the hospitalisation rate was higher in females than in males (129 compared to 47 per 100,000 population).

Figure 1: Rate of hospitalisation for osteoporosis, people aged 50 and over, by age and sex, 2015–16

The vertical bar chart shows that in 2015–16, the hospitalisation rate for the principal diagnosis of back problems was greater for females than males. The hospitalisation rate increased with age for males, but decreased in the 85 and over age group for females.

Source: AIHW National Hospital Morbidity Database (Data table).

Minimal trauma fractures

Minimal trauma fractures may be the result of osteoporosis, which is commonly undiagnosed prior to a fracture. A range of other factors, such as high bone turnover, low body weight and a tendency to fall, also contribute to minimal trauma fracture risk. As osteoporosis is not common before the age of 50, minimal trauma fractures occurring in people age 50 or over are more likely to be a result of osteoporosis.

In 2015–16:

  • there were 81,000 hospitalisations for minimal trauma fractures in people aged 50 and over
  • the hospitalisation rate for minimal trauma fractures in people aged 50 and over was higher in females (1,262 per 100,000 people) than in males (598 per 100,000)
  • of all hospitalisations for minimal trauma fractures for people aged 50 and over, 36% were for people aged 85 and over
  • the most common fracture sites were the hip (32%), the forearm (13%) and lumbar spine and pelvis (13%).

Figure 2: Hospitalisations following minimal trauma by fracture site, people aged 50 and over, 2015–16

Figure 2 shows that the age-standardised acute care hospitalisation rate for back problems increased slightly between 2006–07 to 2015–16 (from 621 to 722 per 100,00 population), while the hospitalisation rate for sub-acute and non-acute care increased nearly 3 times (from 73 to 218 per 100,00 population).

Source: AIHW National Hospital Morbidity Database (Data table).

Minimal trauma hip fractures

Minimal trauma hip fracture is one of the most serious and debilitating outcomes of osteoporosis [1]. Treatment of this type of fracture invariably requires hospitalisation, may require surgery and may be a source of ongoing pain and disability. These fractures are a considerable burden to the community and the Australian health system [2].

In 2015–16:

  • there were 25,700 hospitalisations for minimal trauma hip fracture among people aged 50 and over
  • the rate of hospitalisation for minimal trauma hip fracture was more than one and a half times as high for females (370 per 100,000 people) compared to males (209 per 100,000)
  • hospitalisation rates were highest in those aged 85 and older (2,600 per 100,000 people, compared with 17 per 100,000 people aged 50–54).

Figure 3: Rate of hospitalisations for minimal trauma hip fractures, people aged 50 and over, 2015–16

The vertical bar chart shows that the hospitalisation rates for minimal trauma hip fracture among people aged 50 and over were highest in people aged 85 and older.

Source: AIHW National Hospital Morbidity Database (Data table).

Between 2006–07 and 2015–16, the age-standardised acute care hospitalisation rate for minimal trauma hip fractures decreased slightly (by 11%). Over the same period the rate for sub-acute and non-acute care increased by 33% (Figure 4).

Figure 4: Age-standardised rate of hospitalisations for minimal trauma hip fractures (any diagnosis), by care type, 2006–07 to 2015–16

Figure 4 shows that between 2006–07 and 2015–16, the age-standardised acute care hospitalisation rate for minimal trauma hip fractures decreased by 11%25, while the rate for sub-acute and non-acute care increased by 33%25.

Note: Age-standardised to the 2001 Australian population.

Source: AIHW National Hospital Morbidity Database (Data table).

References

  1. Ip TP, Leung J & Kung AWC 2010. Management of osteoporosis in patients hospitalized for hip fractures. Osteoporosis International 21 (Suppl 4):S605–S614.
  2. Watts JJ, Abimanyi-Ochon J & Sanders KM 2013. Osteoporosis costing all Australians: A new burden of disease analysis–2012 to 2022. Sydney: Osteoporosis Australia.