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Table 3 Overview of the model assumptions

From: Expected lifetime numbers and costs of fractures in postmenopausal women with and without osteoporosis in Germany: a discrete event simulation model

Assumptions regarding event probabilities

Impact§

We applied osteoporosis prevalence rates and BMD-values from US-NHANES III reference data

***

We estimated “total” fracture probabilities by dividing fracture probabilities based on hospital cases with age-independent hospital probabilities

**

We assumed highest fracture related NH probability when more than one fractures occurs in the same time interval

**

We modeled fracture related entry in a NH only after a hospital stay

**

We assumed that only NH entries within 3 months after a fracture may be attributable to the fracture event itself

**

We applied age-dependent relative fracture risk by one standard deviation decrease in BMD to hip fractures and age-independent relative risks to other fractures

**

We assumed that osteoporosis risk attributions were calculated exclusively on BMD values measured at the femoral neck

**

We assumed that osteoporosis prevalence rates do not differ between women living in a NH and women who do not

*

We applied relative fracture risk and prevalence for previous fractures from an international meta-analysis

*

We applied relative fracture risk by one standard deviation decrease in BMD from international studies

*

We applied fracture mortality data from a Canadian study

*

We assumed the highest fracture excess mortality when more than one fracture occurs in the same time interval

*

We allowed first entry in a NH firstly for women aged 65 or older

*

We assumed that individuals in a NH remain there for their remaining lifetime

*

We assumed that patients with osteoporosis will have osteoporosis for their remaining lifetime

*

We allowed a maximum possible age of 100 years

*

Assumptions regarding costing

 

We assumed that rehabilitation probabilities after a hospital stay do not differ between women living in NH and those who do not.

**

We applied Austria data for average hours of informal and professional home care by fracture type, also we assumed that the consumed hours are equivalent for hip, other femur and pelvis

**

We assumed age-dependent fracture unit costs

*

We assumed that the outpatient costs for humerus and wrist as well as the costs for pelvis, other femur and hip fractures are equivalent

*

We took outpatient resource use data from a study considering fracture patients with inflammatory bowel disease

*

We assumed that average informal and professional home care costs are only applicable for individuals not living in NH aged older than 65 years

*

  1. §Expected impact on modeling results: * = low impact, ** = medium impact, *** = high impact.