OBJECTIVES: Currently, there is limited data available on the economic burdens of osteoporosis-related fractures in developing nations, particularly in sub-Saharan countries. The aim of this study was to investigate the direct healthcare costs for inpatients with osteoporotic (OP) fractures and the factors influencing these costs in Nigeria.

METHODS: We examined the medical records system for inpatients (≥50 years-of-age) who received surgical or non-surgical intervention for OP at the National Orthopedic Hospital in Enugu between 2016 and 2020. Data on direct healthcare costs incurred during their hospitalizations were inflation-adjusted and categorized as service, diagnosis, treatment, medical supplies, and pharmaceutical costs. As a control, total medical costs for contemporaneous inpatients with osteoporosis were also collected.

RESULTS: A total of 120 OP fracture inpatients and 640 controls were included. The median cost for OP fractures per patient was $758 US dollars, which is 3-fold higher than the cost for inpatients with osteoporosis ($203, P < 0.001). The direct cost of medical materials accounted for the largest proportion (29%), followed by pharmaceuticals (25%), treatment (21%), services (19%), and diagnosis (6%). The median number of hospital admissions for OP inpatients was 2 times, with a median length of stay of 28 days. The major factors influencing the health care costs of OP inpatients were: intervention approach ($978 for surgical intervention versus $182 for non-surgical intervention, P < 0.001); infection of injury site ($1,112 for infected site versus $455 for non-infected site, P < 0.001); and prior traditional bonesetter (TBS) encounter ($284 for those who encountered TBS versus $182 for those who did not encounter TBS, P < 0.01).

CONCLUSIONS: Medical supplies and pharmaceuticals accounted for more than half of the direct healthcare costs for inpatients with OP fractures. Surgical intervention, an infected injury site, and a previous TBS encounter were factors that directly impacted on the healthcare costs.