Supplementary Table S1: Summary of data sources and costing methods

Healthcare resource utilization by sector / Data Source / Costing assumption/method
Acute care (hospitalization admissions) / CIHI- Discharge Abstract Database (DAD) /
  • RIW multiplied by CPWC ($5,917) for hospital budget portion
  • Inpatient physician fees added for length of stay, diagnostic interventions, and procedures

Emergency visits, same day surgery, hospital-based clinics / CIHI -National Ambulatory Care Reporting System (NACRS) for Ontario and Alberta /
  • RIW multiplied by CPWC ($5,917) for hospital budget portion
  • Inpatient physician fees added for length of stay, diagnostic interventions, and procedures
  • Projected to national level based on data from Ontario, Alberta

Rehabilitation admissions / CIHI - National Rehabilitation Reporting System (NRS) /
  • 2008 published average cost per admission inflated by consumer price index for health care

Rehabilitation clinics / CIHI - National Rehabilitation Reporting System (NRS) /
  • RIW multiplied by CPWC ($5,917) per visit multiplied by number of visits, by type of fracture
  • Alberta: use of rehab clinics by fracture type extrapolated to the national level

Long-term care / CIHI - Continuing Care Reporting System (CCRS) for Ontario /
  • Case mix index multiplied by average cost perday for case mix index multiplied by duration of stay

Home care services / CIHI - Home Care Reporting System (HCRS) for Ontario /
  • Case mix index multiplied by average cost per day for case mix index multiplied by duration of stay

Prescription drugs / IMS Brogan /
  • All public and private drugs prescribed for osteoporosis in Canada

Outpatient physician services / Province of Manitoba analysis. Hopkins et al. 2013 /
  • Number of post-fracture physician visits was subtracted from the number of physician visits for matched controls to derive excess visits, by age, sex and type of fracture

Mobility devices / CIHI - Continuing Care Reporting System (CCRS);Home Care Reporting System (HCRS); InterRai Minimum Data Set (MDS) /
  • From long-term care or home care assessments: use of mobility devices (cane, walker, motorized wheel chair) multiplied by average local costs of devices

Patient and caregiver productivity losses / Calculated using Canadian MulticentreOsteoporosis Study (CaMos) and Statistics Canada /
  • Wage loss: Based on all days spent in acute care institutions (admissions, emergency, rehab, continuing care) multiplied bylabour participation rates multiplied by average wage
  • Caregiver time loss: Based on CaMos [21] and CIHI data: number of osteoporosis-related admissions multiplied by % of patients using caregivers (47.2%) multiplied by average number of days of care (37 days) multiplied by % ofcaregivers being employed(35.8%) multiplied by average dailywage ($25.89 per hour x 8h)

CIHI: Canadian Institute for Health Information; CPWC: cost per weighted case ($5,917); RIW: resource intensity weight