| アブストラクト | The cost of hip fractures, which likely cause a secondary fracture, is a heavy burden. To address this issue, the Japanese government launched a new medical reimbursement policy in April 2022: hospitals that give patients with hip fractures appropriate tests and treatments for osteoporosis after the surgery earn extra fees. Aiming to evaluate the impact of this scheme, we calculated transitional change of test and administration rates of each anti-osteoporosis medicine using Diagnosis-Procedure-Combination data for FY2020 to FY2022. As a result, 846 eligible hospitals were categorized into the fracture-liaison-service (FLS) group of 555, which applied for the new policy, or the non-FLS group of 291, which did not apply. In the 846 hospitals, the total administration rates of osteoporosis medication increased significantly between FY2021 and FY2022, 27.6 +/- 0.7 (mean +/- standard error) and 46.6 +/- 0.9, respectively, at the same time of the implementation of the new reimbursement policy, despite no significant change between FY2020 and FY2021. The administration rates of medicines, Alendronate, Risedronate, and Denosumab, recommended strongly by "The Japanese Guideline for Prevention and Treatment of Osteoporosis 2015," increased significantly not only in the FLS group, 10.8 +/- 0.6 and 21.1 +/- 0.9, but also in the non-FLS group, 6.2 +/- 0.5 and 9.4 +/- 0.9, between FY2021 and FY2022. The test rates showed a similar tendency. The substantial increase in the test rates and administration rates are considered to be primarily attributable to the newly implemented policy, with a partial contribution from the published guidelines. |
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