A systemwide approach to secondary fracture prevention—the New South Wales Osteoporosis Refracture Prevention Initiative was associated with reduced refractures and was economically sustainable
Authors' conclusion
Systemwide FLS implementation was associated with a reduction in minimal trauma refractures requiring hospital admission.
Study context
- Population
- New South Wales, Australia; patients with minimal trauma fractures
- Comparison
- Systemwide Fracture Liaison Service (FLS) implementation (Osteoporosis Refracture Prevention (ORP) Initiative) vs business-as-usual projected expected numbers
- Outcome
- Minimal trauma refractures requiring hospital admission vs expected
- Follow-up
- FY 2022-2023 (5 years after implementation)
Methodological detailslinked administrative data, business-as-usual projections from historical trends, cost-benefit analysis
- Linked administrative data
- Business-as-usual projections from historical trends
- Cost-benefit analysis
Main finding
As reported in the abstract
Fewer minimal trauma refractures requiring hospital admission that year (17% reduction)
1246
Fewer inpatient separations/admissions for refractures (21.4% reduction)
3030
Further findings
Cumulative refractures and admissions vs expected · 5-year study period
- Fewer minimal trauma refractures requiring hospital admission (13.6% reduction; p = 0.018)
- 5329
- Fewer inpatient admissions for refractures (14.7% reduction; p = 0.002)
- 11,070
Probability of minimal trauma refracture requiring hospital admission within 2 years of initial fracture
- Decreased from 9.2% to 8.5% (p < 0.0001)
Economic return per dollar spent on ORP
- Economic return per dollar spent
- AUD1.60
Original publication
A systemwide approach to secondary fracture prevention—the New South Wales Osteoporosis Refracture Prevention Initiative was associated with reduced refractures and was economically sustainable. Osteoporos Int. Published 7 August 2026. doi:10.
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