Impact of the guidance on fracture Liaison Services and the introduction of a new fee for secondary fracture prevention in Japan: Implementation of secondary fracture prevention during hospitalization for fragility fractures
Authors' conclusion
The publication of FLS-CS had no apparent effect on the implementation of secondary fracture prevention in patients with either hip or vertebral fractures. Conversely, the introduction of the management fee had the effect of increasing that for the target disease.
Study context
- Population
- Patients aged ≥50 years hospitalised with surgically treated hip fracture or with vertebral fracture, Japan
- Exposure
- Before vs after publication of Fracture Liaison Service Clinical Standard (FLS-CS) (2019) and introduction of a management fee for secondary fracture prevention (2022)
- Outcome
- Implementation of secondary fracture prevention during hospitalization for fragility fractures
Methodological detailsclaims data, Quality Indicator/Improvement Project database, separate analyses for hip and vertebral fractures
- Claims data
- Quality Indicator/Improvement Project database
- Separate analyses for hip and vertebral fractures
Main finding
As reported in the abstract
Secondary fracture prevention, hip fractures
After FLS-CS: monthly rate of change, IRR
0.985
95% CI 0.979–0.991
After management fee: immediate change, IRR
1.890
95% CI 1.761–2.029
After management fee: monthly rate of change, IRR
1.050
95% CI 1.044–1.056
Observational data: associations, not effects.
Further findings
Secondary fracture prevention, vertebral fractures
- Increase only immediately after management fee, IRR
- 1.148 (95% CI 1.038-1.270)
Original publication
Impact of the guidance on fracture Liaison Services and the introduction of a new fee for secondary fracture prevention in Japan: Implementation of secondary fracture prevention during hospitalization for fragility fractures. Osteoporos Int. Published 13 December 2024. doi:10.
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