Incidence and mortality of hip fracture among the elderly population in South Korea: a population-based study using the National Health Insurance claims data

Abstract

BackgroundThe lack of epidemiologic information on osteoporotic hip fractures hampers the development of preventive or curative measures against osteoporosis in South Korea. We conducted a population-based study to estimate the annual incidence of hip fractures. Also, we examined factors associated with post-fracture mortality among Korean elderly to evaluate the impact of osteoporosis on our society and to identify high-risk populations.MethodsThe Korean National Health Insurance (NHI) claims database was used to identify the incidence of hip fractures, defined as patients having a claim record with a diagnosis of hip fracture and a hip fracture-related operation during 2003. The 6-month period prior to 2003 was set as a 'window period,' such that patients were defined as incident cases only if their first record of fracture was observed after the window period. Cox's proportional hazards model was used to investigate the relationship between survival time and baseline patient and provider characteristics available from the NHI data.ResultsThe age-standardized annual incidence rate of hip fractures requiring operation over 50 years of age was 146.38 per 100,000 women and 61.72 per 100,000 men, yielding a female to male ratio of 2.37. The 1-year mortality was 16.55%, which is 2.85 times higher than the mortality rate for the general population (5.8%) in this age group. The risk of post-fracture mortality at one year is significantly higher for males and for persons having lower socioeconomic status, living in places other than the capital city, not taking anti-osteoporosis pharmacologic therapy following fracture, or receiving fracture-associated operations from more advanced hospitals such as general or tertiary hospitals.ConclusionThis national epidemiological study will help raise awareness of osteoporotic hip fractures among the elderly population and hopefully motivate public health policy makers to develop effective national prevention strategies against osteoporosis to prevent hip fractures.

Health and Economic Burden of Major Cancers Due to Smoking in Korea

“…The NHIC is the exclusive insurer of the Korean social health insurance system, and NHIC claims records represent medical care covered by the Korean insurance program (Kang et al, 2010). Claims records from 2008 associated with the major cancers due to smoking were obtained.…”

The prevalence of osteoporosis in Korean adults aged 50 years or older and the higher diagnosis rates in women who were beneficiaries of a national screening program: The Korea National Health and Nutrition Examination Survey 2008–2009

“…(3) The 1-year mortality for hip fracture among the elderly population in Korea was 16.6%, which is 2.85 times higher than the mortality rate for the general population (5.8%), based on Korean National Health Insurance claims data. (4) For the prevention of osteoporotic fracture, adequate screening and treatment are important. However, despite the recommendation of the U.S. Preventive Services Task Force, the National Osteoporosis Foundation, and the American College of Physicians, (5)(6)(7) most individuals with osteoporosis remain undiagnosed and untreated in the United States.…”

Analysis of Mortality in Patients With a Fracture of the Proximal Femur

“…Через 1 год после перелома летальность, по данным ли-тературы, варьирует в очень широком диапазоне от 14,85 до 48,5%, хотя в большинстве работ показатель составляет 21 -34% [10, 15,16,17,18,19,20,21,22,23,24,34]. В про-веденном исследовании летальность через год составила 29,82%, то есть была сопоставима.…”

“…По данным разных авто-ров [8, 9, 10,11,12], летальность в стационаре среди па-циентов пожилого и старческого возраста с ППОБ состав-ляет от 4,31% до 6,3%; через 4 месяца после травмы -от 15,9% до 20% [13,14]; через 1 год после перелома -14,85 -48,5% [10,15, 16,17,18, 19, 20,21,22,23, 24]; через 2 года данный показатель уже составляет от 36,2 до 39,0% [9,18].…”