• Zoltán Vokó, Katalin Gáspár, András Inotai, Csaba Horváth, Katalin Bors, Gábor Speer, and Zoltán Kaló.
• Department of Health Policy and Health Economics, Institute of Economics, Faculty of Social Sciences, Eötvös Loránd University, Budapest, Hungary.
• J Eval Clin Pract. 2017 Dec 1; 23 (6): 1375-1380.

Rationale, Aims, And ObjectivesTo compare the effect of osteoporotic fractures and complications of diabetes mellitus on quality of life (QoL).MethodA cross-sectional study was performed in 840 patients with osteoporosis and in 943 patients with diabetes in Hungary to estimate the effect of osteoporotic fractures and microvascular and macrovascular complications of diabetes on QoL using the EQ-5D questionnaire. Ordinary least-squares regression was performed for the analysis to control for age and gender.ResultsThe effects of certain of osteoporotic fractures and diabetes complications were similar in size measured by the EQ-5D. Patients with hip fractures and compressions of the vertebrae suffered more than 0.2 drop in their QoL, which is comparable in size to the most severe complications of diabetes, such as vision loss and amputations.ConclusionsThe use of mortality and premature mortality as the traditional measures of disease burden in public health policy making means that diseases which strongly affect QoL but less survival might not get the necessary priority. This is especially the case in low-income and middle-income countries where studies on QoL are scarce. Our comparative analysis, which showed that osteoporotic fractures reduce QoL as much as major complications of diabetes, highlights the need for comprehensive disease burden assessment, including losses in functionality and QoL, to support decision making.© 2017 John Wiley & Sons, Ltd.

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