Determinants of medical costs in patients with and without fractures using Korean Senior Cohort Study

As a population ages rapidly, fractures become a major contributor to hospital visits and increasing healthcare costs. However, the factors influencing healthcare costs among patients with and without fractures in Korea are not well understood. Our study aimed to identify the determinants of medical costs associated with fractures. We utilized the Korean National Health Insurance Service (NHIS)-Senior sample cohort database from 2002 to 2019. Patients with newly diagnosed fractures were classified as having hip fracture, vertebral fracture, non-vertebral non-hip fracture, and/or osteoporosis. We calculated the medical costs and the length of stay (LOS) for the period from 2010 to 2019 using NHIS claims data. Among 208,623 older adults, 78,096 (37.4%) had experienced fractures. Compared to their counterparts without fractures, these patients were predominantly female and older, were more commonly Medical Aid recipients, had lower income, were more likely to have obesity, engaged in less intense physical activity, and had more comorbidities. The mean medical costs for patients with fractures were USD $23,300, compared to $16,000 for those without fractures. Factors contributing to increased medical costs included fracture, male sex, older age, disability, Medical Aid enrollment, higher income, obesity, smoking, and comorbidities (chronic renal disease, arthritis, dementia, and higher Charlson Comorbidity Index). Substantial factors contributing to the rising medical costs and LOS include fracture, older age, Medical Aid enrollment, lower level of physical activity, and comorbidities. Management strategies are required to address these elements.