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Un-edited statements from the health sector and beyond

Vitamin D use linked with fewer fracture admissions

MidCentral District Health Board Friday 31 August 2012, 09:19AM

Media release from MidCentral District Health Board

The improved use of vitamin D by aged residential care (ARC) residents in MidCentral District Health Board's region has coincided with a corresponding reduction in those residents presenting with fractures at Palmerston North Hospital.

MDHB has been working with ACC, who developed a programme to increase the use of vitamin D supplements to residents in residential care facilities, to prevent falls, and ACC claims from residents.

Before the project started in the MidCentral district 15% of residential care residents had had a vitamin D product dispensed for them. The rate steadily increased over the two years of the project to finish at 74% - just short of the 75% target.

MDHB compared the number of presentations to ED, and hospital admissions, in the 18 months before and 18 months after the project started. It found a 32% reduction in presentations to ED and a 41% reduction in hospital admissions for fractures.

MDHB's pharmacy advisor Andrew Orange, says while the reductions are pleasing "they cannot be considered to be solely caused by any increase in vitamin D use. However, given the international evidence available, it is very likely that increased vitamin D utilisation has contributed at least in part to the reduced use of MidCentral Health resources by MidCentral ARC residents for the management of fractures."

Mr Orange said the reduced use of ED and inpatient resources is also likely to have a ripple effect by requiring a reduced need for clinical support and other services such as hospital pharmacy, physiotherapy, and rehabilitation services.

Most admissions for fracture for the ARC population examined were for fractures of the femur (hip fracture). In the 18 months before the project there were 134 admissions of ARC residents where the main diagnosis was 'fracture', with an estimated cost of $1.929m. In the 18 months after the project started there were 79 "fracture' ARC patients with an estimated cost of $1.230m - a difference of 55 patients and more than $705,000.

MDHB says in taking into account ACC funding and the reduced $705,000 costs to the DHB, minus the cost of dispensing vitamin D, the return on investment in increasing use of vitamin D is $540,821.

"While not proven by the data available, it seems reasonable to conclude that the health of ARC residents has benefited from the project by way of reduced harm associated with fracture, which is often considerable in the population in question.

"Continued use of vitamin D in residential care should help to keep people out of hospital and contribute toward the Government health target of reduced waiting times in ED."

  • Vitamin D is critical for muscle and bone strength.  Good muscle strength helps to keep people steady, balanced and moving, and reduces the risk of falling, while good bone strength helps to reduce any fracture that might be caused by a fall.
  • Vitamin D is in some foods (e.g. margarine, yellow-top milk, etc.) but with a healthy diet it is difficult to get enough vitamin D from food to prevent falls.  Most vitamin D comes from the action of sunlight on our skin.  Being outside for a few minutes each day is usually enough to keep our vitamin D stores healthy.  This has to be carefully balanced against the risks of too much sunlight.  As we age, our skin loses the ability to use sunlight to create vitamin D and when this is combined with staying indoors the chances of being vitamin D deficient increase.

Note: The vitamin D used in the project is a Prescription Medicine, so people need a prescription before the pharmacist can dispense it for them.
There are vitamin D supplements available in supermarkets but people should check with their pharmacist or doctor if they have any questions about vitamin D supplements.

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