Liu J, Gong T, Xu X, et al. - Elderly women who had a fracture during the previous 2 years were at a very significant risk of subsequent fracture and high healthcare utilization and cost, particularly those with vertebral or multiple fractures. However, the prevalence of fracture prevention interventions was low. More effort is required to identify and treat people who are at extremely high risk of fracture.

• Participants in the study were 43,193 patients.

• The 5-year probability for major fracture was 0.36, and 0.11 and 0.17 for hip fracture and vertebral fracture, respectively, which was significantly higher than the guidelines' 10-year probability levels for very-high-risk fractures (0.3 for major fracture, 0.045 for hip fracture).

• In year one, the rates of hospitalizations, emergency department visits or observation stays, and skilled nursing facility stays were 53.7, 57.0, and 18.8 per 100 patient-years, respectively, with rates dropping somewhat in future years.

• In year one, the average healthcare expenditure was $23,700, but by year five, it had dropped to $18,500.

• In year one, approximately 29.1% of patients got osteoporosis medicines, which decreased to 16.9% by year five.

• Rates of all outcomes, particularly fractures, were significantly greater in the vertebral and multiple fracture populations.