Comparative outcomes of osteoporotic fracture management between tertiary hospitals and fracture liaison services in Malaysia.

Osteoporotic fractures pose a significant health challenge, particularly among the elderly, resulting in diminished quality of life, increased morbidity and mortality, and substantial healthcare costs. In Malaysia, the incidence of osteoporotic fractures is expected to increase due to the country’s ageing population. This study evaluates the outcomes of osteoporotic fracture management in standard tertiary care (STC) hospitals compared to those in a Fracture Liaison Service (FLS)- accredited hospital. A retrospective cohort study was conducted in three STC hospitals and one FLS-accredited hospital. Medical records of patients aged 50 and above with osteoporotic fractures admitted to orthopaedic wards in 2021 were analysed. Data on demographics, clinical characteristics, and secondary fracture prevention measures were collected and compared. Statistical analysis was performed using IBM-SPSS software. At discharge, 66.0% of FLS patients were prescribed anti-osteoporosis medications compared to just 4.2% in STC hospitals (p < 0.001), with this trend continuing at six months (66.0% vs. 12.5%, p < 0.001). Supplement use was also higher among FLS patients (79.6% vs. 17.6%, p < 0.001), as was the rate of bone mineral density testing (40.8% vs. 2.3%, p < 0.001). In terms of recovery, FLS patients showed better post-fracture mobility (83.7% vs. 58.8%, p = 0.037) and greater independence at discharge (53.7% vs. 18.1%, p < 0.001). The study highlights a significant disparity between the two care models, particularly in secondary fracture prevention practices. These findings underscore the necessity for widespread implementation of structured fracture care programs to enhance patient outcomes.