Fragility fractures (FF) are the main clinical consequence of osteoporosis. FF lead to a loss in quality of life (QL), increased dependency and higher costs due to loss of productivity. Despite this, very few studies have been performed about the indirect or social costs of FF. The objective of this review was to systematically synthesize published evidence regarding indirect costs of FF. We conducted a systematic literature review of empirical studies published as peer review papers between 1998 and 2019. A total of 295 papers were found about costs and osteoporosis. After an iterative process, only 16 papers fit the criteria of selection. Despite the important consequences for QL, only seven studies have included research of the issue and only one about dependency. Treatments are cost-effective, but adherence is low. Multiple fractures, older age and low socioeconomic profile imply higher costs. Most studies are performed using the human capital methodology. The main two variables are loss of productivity and absenteeism. Most of the people included in the samples are out of the active population. Those studies that include a follow-up period vary in a range between 3 months and 2 years. Depending on sample and methodology, the indirect costs (IC) are between 2 and 50%. The direct costs associated with FF generally far outweigh the IC. There is a lack of studies about the effects of treatments and adherence and about the dependency system. The changing role of women in coming generations will increase indirect costs.

脆性骨折（FF）是骨质疏松症的主要临床后果。FF导致生活质量（QL）下降，依赖性增加以及生产力下降导致成本增加。尽管如此，关于FF的间接或社会成本的研究很少。这篇综述的目的是系统地综合已发表的关于果蝇间接成本的证据。我们对1998年至2019年期间发表为同行评议论文的经验研究进行了系统的文献综述。共发现295篇关于成本和骨质疏松的论文。经过一个反复的过程，只有16篇论文符合选择标准。尽管这对QL产生了重要的影响，但只有七项研究包含了对该问题的研究，而只有一项涉及依赖性。治疗具有成本效益，但依从性低。多处骨折 老年人和低社会经济状况意味着更高的成本。大多数研究是使用人力资本方法进行的。主要的两个变量是生产力损失和旷工。样本中包含的大多数人不在活动人口中。这些包括随访期的研究在3个月至2年之间不等。根据样本和方法，间接成本（IC）在2％到50％之间。与FF相关的直接成本通常远远超过IC。缺乏关于治疗和依从性以及依赖系统的研究。妇女在后代中的角色变化将增加间接成本。主要的两个变量是生产力损失和旷工。样本中包含的大多数人不在活动人口中。这些包括随访期的研究在3个月至2年之间不等。根据样本和方法，间接成本（IC）在2％到50％之间。与FF相关的直接成本通常远远超过IC。缺乏关于治疗和依从性以及依赖系统的研究。妇女在后代中的角色变化将增加间接成本。主要的两个变量是生产力损失和旷工。样本中包含的大多数人不在活动人口中。这些包括随访期的研究在3个月至2年之间不等。根据样本和方法，间接成本（IC）在2％到50％之间。与FF相关的直接成本通常远远超过IC。缺乏关于治疗和依从性以及依赖系统的研究。妇女在后代中的角色变化将增加间接成本。与FF相关的直接成本通常远远超过IC。缺乏关于治疗和依从性以及依赖系统的研究。妇女在后代中的角色变化将增加间接成本。与FF相关的直接成本通常远远超过IC。缺乏关于治疗和依从性以及依赖系统的研究。妇女在后代中的角色变化将增加间接成本。