Inpatient cost of treating osteoporotic fractures in mainland China: a descriptive analysis

Figures & data

Figure 1 Patient flowchart.

Note: *Outliers included length of stay >400 days and hospitalization costs >¥50,000 or ≤¥300.
Abbreviations: N, total number; n, sample number.

Table 1 Osteoporotic fracture patient demographics

Total patients with fracture N=830	n	Distribution
Sex
Male	188	22.7%
Female	642	77.3%
Age group
All (excluding unspecified)	823	–
Mean (SD)	73.4 (9.8)
50–59 years	92	11.1%
60–69 years	152	18.3%
70–79 years	350	42.2%
80+ years	229	27.6%
Unspecified	7	0.8%
Insurance type
Employed (UEBMI)	678	81.7%
Resident (URBMI)	141	17.0%
Unspecified	11	1.3%
Area
East	695	83.7%
Center	59	7.1%
West	76	9.2%
City level
Provincial capitals/municipalities	676	81.5%
Prefecture/subprefecture cities	143	17.2%
County-level cities	11	1.3%
Hospital level
Community and township hospitals	11	1.3%
Hospital tier
1	20	2.4%
2	243	29.3%
3	556	67.0%

Abbreviations: N, number of patients in group; n, number of affected patients; SD, standard deviation; UEBMI, Urban Employee Basic Medical Insurance; URBMI, Urban Resident Basic Medical Insurance.

Table 2 Fracture sites per year, 2008–2010

Fracture site	Total		2008			2009			2010
	N=830 n	%	N=107 n	Within 2008 %	Over 3 years 2008–2010* %	N=255 n	Within 2009 %	Over 3 years 2008–2010* %	N=468 n	Within 2010 %	Over 3 years 2008–2010* %
Vertebral	270	32.5%	31	29.0%	11.5%	83	32.5%	30.7%	156	33.3%	57.8%
Hip	256	30.8%	33	30.8%	12.9%	93	36.5%	36.3%	130	27.8%	50.8%
NVNH	265	31.9%	33	30.8%	12.5%	78	30.6%	29.4%	154	32.9%	58.1%
Multiple fractures	6	0.7%	2	1.9%	33.3%	1	0.4%	16.7%	3	0.6%	50.0%
Unspecified	33	4.0%	8	7.5%	24.2%	0	0.0%	0.0%	25	5.3%	75.8%

Note:

* Percent values calculated as the current year fracture total divided by the 3-year total for the specific fracture type.

Abbreviations: N, number of patients in group; n, number of affected patients; NVNH, nonvertebral/nonhip.

Table 3 Hospital length of stay and hospitalization costs by patient characteristics, insurance type, and fracture type, 2008–2010

	N	Mean ± SD	Median	Max	Min	Range	P-value (Kruskal–Wallis)	P-value (Wilcoxon)
Total	830	22.5±18.3	19	181	1	180
Sex								0.478
Male	188	21.5±16.1	18	126	4	122
Female	642	22.8±19.0	19	181	1	180
Age group							0.023
50–59 years	92	21.0±17.7	17	99	1	98
60–69 years	152	21.6±19.0	17	126	2	124		0.138a
70–79 years	350	23.4±18.7	19	181	1	180		0.312
80+ years	229	22.6±17.8	19	126	1	125
Unspecified	7	14.9±8.5	14	31	6	25
Insurance type							0.002
Employed (UEBMI)	678	23.3±19.1	19	181	1	180
Resident (URBMI)	141	18.7±13.9	16	93	1	92
Unspecified	11	24.6±13.3	27	43	7	36
Fracture sites							0.0001
Vertebral	270	20.2±17.6	15	126	1	125		<0.0001b
Hip	256	27.1±19.4	22	181	2	179		<0.0001c
NVNH	265	21.1±18.3	18	177	1	176		0.0528d
Multiple fractures	6	18.2±13.4	13.5	43	8	35
Unspecified	33	17.7±8.0	16	35	5	30
Hospital costs (¥)
Total	830	24,599±22,064	18,587	156,501	352
Sex								0.1454
Male	188	27,452±25,542	20,391	156,501	374
Female	642	23,763±20,886	17,787	133,700	352
Age group							0.0852
50–59 years	92	19,623±17,976	14,623	95,590	2,215
60–69 years	152	22,670±23,347	15,530	156,501	484			0.1767a
70–79 years	350	26,205±22,542	21,091	133,700	915			0.6983
80+ years	229	25,626±21,899	21,930	127,196	352
Unspecified	7	17,966±12,255	11,358	35,656	5,559
Insurance type							0.0353
Employed (UEBMI)	678	25,451±21,992	19,479	146,481	837	145,643
Resident (URBMI)	141	22,298±22,214	16,418	156,501	944	155,556
Unspecified	11	1,608±1,235	1,305	3,983	352	3,631
Fracture sites							0.0001
Vertebral	270	19,239±20,503	10,493	120,813	374	120,439		<0.0001b
Hip	256	34,202±22,867	32,594	133,700	837	132,863		<0.0001c
NVNH	265	22,034±20,084	17,185	156,501	529	155,972		0.0046d
Multiple fractures	6	27,513±35,265	8,905	80,077	352	79,725
Unspecified	33	13,440±15,195	8,599	57,325	983	56,343

Notes:

a Comparison of inpatients aged 60–69 years versus those aged 80+ years;

b comparison of vertebral fracture versus hip fracture;

c comparison of hip fracture versus NVNH fracture;

d comparison of NVNH fracture versus vertebral fracture. Exchange rate =1 RMB/CNY =0.16 USD.

Abbreviations: N, number of patients in group; SD, standard deviation; Max, maximum; Min, minimum; UEBMI, Urban Employee Basic Medical Insurance; URBMI, Urban Resident Basic Medical Insurance; NVNH, nonvertebral/nonhip; RMB, Renminbi; CNY, Chinese Yuan; USD, United States dollar.

Figure 2 Average per-admission hospitalization costs and patient copayment by year.

Abbreviation: RMB, Renminbi.

Figure 3 Average per-day hospitalization costs by year.

Abbreviations: RMB, Renminbi.

Table 4 Yearly trends in length of stay and costs, 2008–2010

N=830	Defined osteoporosis fractures (N=830) by day
	Hospital length of stay (days)
	Mean ± SD	Median	Max	Min	Range
Total	22.5±18.3	19	181	1	180
Year
2008	24.1±16.6	21	100	1	99
2009	22.9±18.2	19	96	1	95
2010	21.9±18.8	18	181	1	180
Hospital costs (¥)
2008	16,696±19,416	10,234	127,196	352	126,844
2009	24,056±20,673	19,817	126,287	837	125,450
2010	26,701±22,963	21,349	156,501	944	155,556
UEBMI and URBMI cover (reimbursement)
2008	8,655±9,911	4,783	50,605	19.3	50,585
2009	13,160±13,270	7,992	85,454	191	83,263
2010	16,242±17,361	9,002	105,179	0.7	105,178
Individual medical economic burden (copayment)
2008	8,041±16,062	1,025	124,604	0.00	124,604
2009	10,896±14,475	4,954	85,326	0.00	85,326
2010	10,460±15,777	4,722	153,413	0.00	153,413
Hospital costs per day
2008	802±862	506	4,741	35.3	4,706
2009	1,397±1,629	985	14,956	53	14,902
2010	1,517±1,779	1,045	27,260	90.8	27,169

Note:

Exchange rate =1 RMB/CNY =0.16 USD.

Abbreviations: SD, standard deviation; Max, maximum; Min, minimum; UEBMI, Urban Employee Basic Medical Insurance; URBMI, Urban Resident Basic Medical Insurance; RMB, Renminbi; CNY, Chinese Yuan; USD, United States dollar.

Table 5 Length of stay and hospitalization costs per admission, 2010

	Length of stay in 2010 (N=468) (days)					Hospitalization cost in 2010 (N=468) (¥)
	Mean ± SD	Median	Min	Max	P-value (Wilcoxon)	Mean ± SD	Median	Min	Max	P-value (Wilcoxon)
Total	21.9±18.8	18	1	181		26,701±22,963	21,349	944	156,501
Sex					0.823					0.054
Male	22.1±17.1	18	4	126		31,324±27,637	25,417	2,215	156,501
Female	21.9±19.3	18	1	181		25,213±21,070	20,396	944	133,700
Insurance type					0.003					0.013
Employed (UEBMI)	22.9±19.9	18	1	181		27,450±22,378	23,867	1,157	146,481
Resident (URBMI)	17.7±12.3	15	2	74		23,514±25,190	18,130	944	156,501
Fracture type
Vertebral	19.2±16.7	15	1	126		21,078±22,073	11,901	944	120,813
Hip	27.5±20.9	22	5	181		37,522±21,009	38,746	3,284	133,700
NVNH	20.9±19.4	17	2	177		25,417±23,112	20,722	949	156,501
Multiple fractures	11.7±4.0	11	8	16		27,336±32,392	14,401	3,410	64,197
Missing	17.1±7.0	17	5	31		13,360±14,579	7,910	1,157	49,471

Note:

Exchange rate =1 RMB/CNY =0.16 USD.

Abbreviations: N, number of patients in group; SD, standard deviation; Min, minimum; Max, Maximum; UEBMI, Urban Employee Basic Medical Insurance; URBMI, Urban Resident Basic Medical Insurance; NVNH, nonvertebral/nonhip; RMB, Renminbi; CNY, Chinese Yuan; USD, United States dollar.