International variation in the incidence of hip fractures: cross-national project on osteoporosis for the World Health Organization Program for Research on Aging.

2.50
Hdl Handle:
http://hdl.handle.net/2336/47080
Title:
International variation in the incidence of hip fractures: cross-national project on osteoporosis for the World Health Organization Program for Research on Aging.
Authors:
Schwartz, A V; Kelsey, J L; Maggi, S; Tuttleman, M; Ho, S C; Jonsson, P V; Poór, G; Sisson de Castro, J A; Xu, L; Matkin, C C; Nelson, L M; Heyse, S P
Citation:
Osteoporos Int 1999, 9(3):242-53
Issue Date:
6-Jan-1999
Abstract:
A cross-national study of hip fracture incidence was carried out in five geographic areas--Beijing, China; Budapest, Hungary; Hong Kong; Porto Alegre, Brazil; and Reykjavik, Iceland--during the years 1990-1992. Cases of hip fracture among women and men of age 20 years and older were identified using hospital discharge data in conjunction with medical records, operating room logs, and radiology logs. Estimated incidence rates varied widely, with Beijing reporting the lowest rates (age-adjusted rate per 100,000 population for men 20 years and older = 45.4; women = 39.6) and Reykjavik the highest rates (man = 141.3; women = 274.1). Rates were higher for women than for men in every area except Beijing. In every area except Budapest, review of the operating room or radiology logs identified additional cases that were not reported in the discharge list, increasing the estimated number of hip fractures by 11% to 62%, depending on the area. Review of medical records identified miscoding of hip fractures (ICD 9820) as 'shaft of femur and other femur fractures' (ICD 9821) in the discharge lists of every area except Budapest, increasing the estimated number of hip fractures by 1% to 30%. The final estimates of hip fracture incidence taking into account all investigated sources of undercount and overcount ranged from 15% lower to 89% higher than an estimate based on the discharge diagnoses alone. Although these results indicate substantial limitations in relying on hospital discharge data alone to estimate hip fracture incidence rates, the extent of errors found in the discharge lists is smaller than the large international variation found here and previously reported in incidence rates. The findings support the conclusion that the differences reported among countries mainly reflect genuine variation in the hip fracture incidence rates.
Description:
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Additional Links:
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Full metadata record

DC FieldValue Language
dc.contributor.authorSchwartz, A V-
dc.contributor.authorKelsey, J L-
dc.contributor.authorMaggi, S-
dc.contributor.authorTuttleman, M-
dc.contributor.authorHo, S C-
dc.contributor.authorJonsson, P V-
dc.contributor.authorPoór, G-
dc.contributor.authorSisson de Castro, J A-
dc.contributor.authorXu, L-
dc.contributor.authorMatkin, C C-
dc.contributor.authorNelson, L M-
dc.contributor.authorHeyse, S P-
dc.date.accessioned2009-01-06T13:44:59Z-
dc.date.available2009-01-06T13:44:59Z-
dc.date.issued1999-01-06-
dc.date.submitted2008-01-06-
dc.identifier.citationOsteoporos Int 1999, 9(3):242-53en
dc.identifier.issn0937-941X-
dc.identifier.pmid10450414-
dc.identifier.doi10.1007/s001980050144-
dc.identifier.urihttp://hdl.handle.net/2336/47080-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractA cross-national study of hip fracture incidence was carried out in five geographic areas--Beijing, China; Budapest, Hungary; Hong Kong; Porto Alegre, Brazil; and Reykjavik, Iceland--during the years 1990-1992. Cases of hip fracture among women and men of age 20 years and older were identified using hospital discharge data in conjunction with medical records, operating room logs, and radiology logs. Estimated incidence rates varied widely, with Beijing reporting the lowest rates (age-adjusted rate per 100,000 population for men 20 years and older = 45.4; women = 39.6) and Reykjavik the highest rates (man = 141.3; women = 274.1). Rates were higher for women than for men in every area except Beijing. In every area except Budapest, review of the operating room or radiology logs identified additional cases that were not reported in the discharge list, increasing the estimated number of hip fractures by 11% to 62%, depending on the area. Review of medical records identified miscoding of hip fractures (ICD 9820) as 'shaft of femur and other femur fractures' (ICD 9821) in the discharge lists of every area except Budapest, increasing the estimated number of hip fractures by 1% to 30%. The final estimates of hip fracture incidence taking into account all investigated sources of undercount and overcount ranged from 15% lower to 89% higher than an estimate based on the discharge diagnoses alone. Although these results indicate substantial limitations in relying on hospital discharge data alone to estimate hip fracture incidence rates, the extent of errors found in the discharge lists is smaller than the large international variation found here and previously reported in incidence rates. The findings support the conclusion that the differences reported among countries mainly reflect genuine variation in the hip fracture incidence rates.en
dc.language.isoenen
dc.publisherSpringer Internationalen
dc.relation.urlhttp://www.springerlink.com/content/8ckd76cy4kxvybvgen
dc.subject.meshAdulten
dc.subject.meshAge Distributionen
dc.subject.meshAgeden
dc.subject.meshAged, 80 and overen
dc.subject.meshBrazilen
dc.subject.meshChinaen
dc.subject.meshFemaleen
dc.subject.meshHip Fracturesen
dc.subject.meshHong Kongen
dc.subject.meshHumansen
dc.subject.meshHungaryen
dc.subject.meshIncidenceen
dc.subject.meshMaleen
dc.subject.meshMedical Recordsen
dc.subject.meshMiddle Ageden
dc.subject.meshSex Distributionen
dc.titleInternational variation in the incidence of hip fractures: cross-national project on osteoporosis for the World Health Organization Program for Research on Aging.en
dc.typeArticleen
dc.contributor.departmentDepartment of Health Research and Policy, Stanford University School of Medicine, California 94305-5405, USA. schwartz@osiris.stanford.eduen
dc.identifier.journalOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USAen

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