Letters | Hong Kong’s elderly and the public health care system would benefit from neighbourhood osteoporosis screenings

Given the long wait time for a bone density scan at public hospitals and the high cost of surgeries to treat fractures, collaboration between the government, NGOs and private doctors and labs at the district level to detect osteoporosis must be encouraged

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An elderly man walks down a street in Sham Shui Po in June. Older adults are prone to bone fractures as a result of osteoporosis. Photo: Edmond So

Published: 7:25am, 14 Oct 2019Updated: 7:25am, 14 Oct 2019

I agree with Professor Jean Woo, director of Chinese University’s Jockey Club Institute of Ageing (“The big picture on health care for the elderly that Hong Kong is missing”, September 27) that “the key thing is to identify people who are going downhill faster before they actually have the diseases and become bedridden or depressed”. Some hidden diseases, which can be prevented, are often left underdiagnosed and can have larger consequences, such as unplanned admission to accident and emergency departments, deteriorating quality of life post-surgery and high costs for caretakers.

Osteoporosis, and its associated bone fractures, in elderly people is one such hidden disease. One in three women and one in five men aged 50 and above globally will experience a fracture at least once in their lifetime. In Hong Kong, the Hospital Authority spends HK$700 million on around 7,000 hip fracture surgeries and related medical costs a year. The rate of post-discharge mortality is high: in one study, 17.3 per cent of patients died within a year of surgery, versus 1.6 per cent in an age-matched control population.

How do you find out if you have osteoporosis? Arrange a dual-energy X-ray absorptiometry (DXA) scan, which takes as little as five minutes and costs around HK$600-800 in a private clinic. Or, in my mother’s case, wait until you have a fall and find out later.

As quick as a DXA scan can be, the wait for one in a public hospital can be more than 15 months or in some cases as long as 7.5 years. The solution: holistic medical-social collaboration at the district level, using neighbourhood resources, such as NGOs, social enterprises, private doctors and labs.

Through health talks and community events in their neighbourhoods, seniors at high risk of osteoporosis can be screened. Health care vouchers for those over 65 could be accepted for these screenings.

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