Osteoporosis is often not the principal diagnosis code related to a health care visit, as the condition is usually an underlying cause of another condition, in particular, fragility fractures that often occur after a fall or other seemingly minor incident. Many times in such health care visits, osteoporosis may not even be listed as a condition. Still, in 2011, primary osteoporosis was listed in 2.3 million hospital discharges and emergency department visits as a reason for the visit. Fragility fractures occurred in 4.0 million visits. For 395,500 visits or discharges for fragility fractures, or 10%, primary osteoporosis was also listed as a condition for the visit. The highest proportion of fractures to the vertebrae and stress fractures were diagnosed in women.
Two-thirds of hospital discharges for fragility fractures occurred in women, while 87% of primary osteoporosis diagnoses were in women. Primary osteoporosis was found in a similar proportion of emergency department visits (89%) for women; however, fragility fractures were split 45% males to 55% females.
Women also were more likely to have a primary osteoporosis diagnosis with a fragility fracture, accounting for 26% of hospital discharges and 10% of emergency department visits. Among men, both diagnoses were found in 7% of hospital discharges and only 1% of emergency department visits. The noted incidence of osteoporosis among men in this situation is most likely underreported as, noted above, men are less likely than women to be evaluated for osteoporosis, even after sustaining a low impact fracture. Evaluation of bone health in men and women after sustaining a low impact fracture and initiation of secondary fracture prevention measures are areas that require significant attention and improvement. (Reference Table 9A.5 PDF CSV)