Pre-fracture individual characteristics associated with high total health care costs after hip fracture
Summary Older women with pre-fracture slow walk speed, high body mass index, and/or a high level of multimorbidity have significantly higher health care costs after hip fracture compared to those without those characteristics. Studies to investigate if targeted health care interventions for these in...
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| Veröffentlicht in: | Osteoporosis international 2017-03, Vol.28 (3), p.889-899 |
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| creator | Schousboe, J. T. Paudel, M. L. Taylor, B. C. Kats, A. M. Virnig, B. A. Dowd, B. E. Langsetmo, L. Ensrud, K. E. |
| description | Summary
Older women with pre-fracture slow walk speed, high body mass index, and/or a high level of multimorbidity have significantly higher health care costs after hip fracture compared to those without those characteristics. Studies to investigate if targeted health care interventions for these individuals can reduce hip fracture costs are warranted.
Introduction
The aim of this study is to estimate the associations of individual pre-fracture characteristics with total health care costs after hip fracture, using Study of Osteoporotic Fractures (SOF) cohort data linked to Medicare claims.
Methods
Our study population was 738 women age 70 and older enrolled in Medicare Fee for Service (FFS) who experienced an incident hip fracture between January 1, 1992 and December 31, 2009. We assessed pre-fracture individual characteristics at SOF study visits and estimated costs of hospitalizations, skilled nursing facility and inpatient rehabilitation stays, home health care visits, and outpatient utilization from Medicare FFS claims. We used generalized linear models to estimate the associations of predictor variables with total health care costs (2010 US dollars) after hip fracture.
Results
Median total health care costs for 1 year after hip fracture were $35,536 (inter-quartile range $24,830 to $50,903). Multivariable-adjusted total health care costs for 1 year after hip fracture were 14 % higher ($5256, 95 % CI $156 to $10,356) in those with walk speed |
| doi_str_mv | 10.1007/s00198-016-3803-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5332123</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1835414120</sourcerecordid><originalsourceid>FETCH-LOGICAL-c470t-94ff53daac8d4b4e6617cdf264510b09367103ef0a43ed44692d27a62a1923863</originalsourceid><addsrcrecordid>eNp1kc1rFTEUxYMo9ln9A7qRATfdjN58TDLZFKTUDyjowkJ34b4k8yZl3uQ1yVT8783j9UMFV4F7f-fkHg4hJxTeUwD1IQNQ3bdAZct74K14RlZUcN4yLbvnZAWaq1YLen1EXuV8A1WjtXpJjphSgoPUK7L5nnw7JLRlSb4Jswt3wS04NXbE_dSnkEuwucGcow1YvGt-hjI2Y9iMTYmloqPHqU4sVgcbc6nwUIUV2TUP1q_JiwGn7N_cv8fk6tPFj_Mv7eW3z1_PP162Vigo9dhh6LhDtL0Ta-GlpMq6gUnRUVjXPFJR4H4AFNw7IaRmjimUDKlmvJf8mJwdfHfLeuud9XNJOJldCltMv0zEYP7ezGE0m3hnOs4ZZbwanN4bpHi7-FzMNmTrpwlnH5dsaM87QQVlUNF3_6A3cUlzjWcYQA9SAt8b0gNlU8w5-eHxGApmX6M51GhqjWZfoxFV8_bPFI-Kh94qwA5Arqt549PT1_93_Q3sO6mh</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2008066033</pqid></control><display><type>article</type><title>Pre-fracture individual characteristics associated with high total health care costs after hip fracture</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Schousboe, J. T. ; Paudel, M. L. ; Taylor, B. C. ; Kats, A. M. ; Virnig, B. A. ; Dowd, B. E. ; Langsetmo, L. ; Ensrud, K. E.</creator><creatorcontrib>Schousboe, J. T. ; Paudel, M. L. ; Taylor, B. C. ; Kats, A. M. ; Virnig, B. A. ; Dowd, B. E. ; Langsetmo, L. ; Ensrud, K. E.</creatorcontrib><description>Summary
Older women with pre-fracture slow walk speed, high body mass index, and/or a high level of multimorbidity have significantly higher health care costs after hip fracture compared to those without those characteristics. Studies to investigate if targeted health care interventions for these individuals can reduce hip fracture costs are warranted.
Introduction
The aim of this study is to estimate the associations of individual pre-fracture characteristics with total health care costs after hip fracture, using Study of Osteoporotic Fractures (SOF) cohort data linked to Medicare claims.
Methods
Our study population was 738 women age 70 and older enrolled in Medicare Fee for Service (FFS) who experienced an incident hip fracture between January 1, 1992 and December 31, 2009. We assessed pre-fracture individual characteristics at SOF study visits and estimated costs of hospitalizations, skilled nursing facility and inpatient rehabilitation stays, home health care visits, and outpatient utilization from Medicare FFS claims. We used generalized linear models to estimate the associations of predictor variables with total health care costs (2010 US dollars) after hip fracture.
Results
Median total health care costs for 1 year after hip fracture were $35,536 (inter-quartile range $24,830 to $50,903). Multivariable-adjusted total health care costs for 1 year after hip fracture were 14 % higher ($5256, 95 % CI $156 to $10,356) in those with walk speed <0.6 m/s compared to ≥1.0 m/s, 25 % higher ($9601, 95 % CI $3314 to $16,069) in those with body mass index ≥30 kg/m
2
compared to 20 to 24.9 mg/kg
2
, and 21 % higher ($7936, 95 % CI $346 to $15,526) for those with seven or more compared to no comorbid medical conditions.
Conclusions
Pre-fracture poor mobility, obesity, and multiple comorbidities are associated with higher total health care costs after hip fracture in older women. Studies to investigate if targeted health care interventions for these individuals can reduce the costs of hip fractures are warranted.</description><identifier>ISSN: 0937-941X</identifier><identifier>EISSN: 1433-2965</identifier><identifier>DOI: 10.1007/s00198-016-3803-4</identifier><identifier>PMID: 27743069</identifier><language>eng</language><publisher>London: Springer London</publisher><subject>Aged ; Aged, 80 and over ; Body Mass Index ; Comorbidity ; Endocrinology ; Female ; Femur Neck - physiopathology ; Fractures ; Generalized linear models ; Health Care Costs - statistics & numerical data ; Health care policy ; Hip ; Hip Fractures - complications ; Hip Fractures - economics ; Hip Fractures - epidemiology ; Hip Fractures - therapy ; Hip joint ; Hospital Costs - statistics & numerical data ; Humans ; Medicare ; Medicare - economics ; Medicine ; Medicine & Public Health ; Mobility Limitation ; Multimorbidity ; Nursing ; Obesity ; Obesity - complications ; Obesity - economics ; Obesity - epidemiology ; Original Article ; Orthopedics ; Osteoporosis ; Osteoporotic Fractures - complications ; Osteoporotic Fractures - economics ; Osteoporotic Fractures - epidemiology ; Osteoporotic Fractures - therapy ; Population studies ; Rehabilitation ; Rheumatology ; United States - epidemiology</subject><ispartof>Osteoporosis international, 2017-03, Vol.28 (3), p.889-899</ispartof><rights>International Osteoporosis Foundation and National Osteoporosis Foundation 2016</rights><rights>Osteoporosis International is a copyright of Springer, (2016). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-94ff53daac8d4b4e6617cdf264510b09367103ef0a43ed44692d27a62a1923863</citedby><cites>FETCH-LOGICAL-c470t-94ff53daac8d4b4e6617cdf264510b09367103ef0a43ed44692d27a62a1923863</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00198-016-3803-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00198-016-3803-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27743069$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schousboe, J. T.</creatorcontrib><creatorcontrib>Paudel, M. L.</creatorcontrib><creatorcontrib>Taylor, B. C.</creatorcontrib><creatorcontrib>Kats, A. M.</creatorcontrib><creatorcontrib>Virnig, B. A.</creatorcontrib><creatorcontrib>Dowd, B. E.</creatorcontrib><creatorcontrib>Langsetmo, L.</creatorcontrib><creatorcontrib>Ensrud, K. E.</creatorcontrib><title>Pre-fracture individual characteristics associated with high total health care costs after hip fracture</title><title>Osteoporosis international</title><addtitle>Osteoporos Int</addtitle><addtitle>Osteoporos Int</addtitle><description>Summary
Older women with pre-fracture slow walk speed, high body mass index, and/or a high level of multimorbidity have significantly higher health care costs after hip fracture compared to those without those characteristics. Studies to investigate if targeted health care interventions for these individuals can reduce hip fracture costs are warranted.
Introduction
The aim of this study is to estimate the associations of individual pre-fracture characteristics with total health care costs after hip fracture, using Study of Osteoporotic Fractures (SOF) cohort data linked to Medicare claims.
Methods
Our study population was 738 women age 70 and older enrolled in Medicare Fee for Service (FFS) who experienced an incident hip fracture between January 1, 1992 and December 31, 2009. We assessed pre-fracture individual characteristics at SOF study visits and estimated costs of hospitalizations, skilled nursing facility and inpatient rehabilitation stays, home health care visits, and outpatient utilization from Medicare FFS claims. We used generalized linear models to estimate the associations of predictor variables with total health care costs (2010 US dollars) after hip fracture.
Results
Median total health care costs for 1 year after hip fracture were $35,536 (inter-quartile range $24,830 to $50,903). Multivariable-adjusted total health care costs for 1 year after hip fracture were 14 % higher ($5256, 95 % CI $156 to $10,356) in those with walk speed <0.6 m/s compared to ≥1.0 m/s, 25 % higher ($9601, 95 % CI $3314 to $16,069) in those with body mass index ≥30 kg/m
2
compared to 20 to 24.9 mg/kg
2
, and 21 % higher ($7936, 95 % CI $346 to $15,526) for those with seven or more compared to no comorbid medical conditions.
Conclusions
Pre-fracture poor mobility, obesity, and multiple comorbidities are associated with higher total health care costs after hip fracture in older women. Studies to investigate if targeted health care interventions for these individuals can reduce the costs of hip fractures are warranted.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Body Mass Index</subject><subject>Comorbidity</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Femur Neck - physiopathology</subject><subject>Fractures</subject><subject>Generalized linear models</subject><subject>Health Care Costs - statistics & numerical data</subject><subject>Health care policy</subject><subject>Hip</subject><subject>Hip Fractures - complications</subject><subject>Hip Fractures - economics</subject><subject>Hip Fractures - epidemiology</subject><subject>Hip Fractures - therapy</subject><subject>Hip joint</subject><subject>Hospital Costs - statistics & numerical data</subject><subject>Humans</subject><subject>Medicare</subject><subject>Medicare - economics</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mobility Limitation</subject><subject>Multimorbidity</subject><subject>Nursing</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Obesity - economics</subject><subject>Obesity - epidemiology</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Osteoporosis</subject><subject>Osteoporotic Fractures - complications</subject><subject>Osteoporotic Fractures - economics</subject><subject>Osteoporotic Fractures - epidemiology</subject><subject>Osteoporotic Fractures - therapy</subject><subject>Population studies</subject><subject>Rehabilitation</subject><subject>Rheumatology</subject><subject>United States - epidemiology</subject><issn>0937-941X</issn><issn>1433-2965</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kc1rFTEUxYMo9ln9A7qRATfdjN58TDLZFKTUDyjowkJ34b4k8yZl3uQ1yVT8783j9UMFV4F7f-fkHg4hJxTeUwD1IQNQ3bdAZct74K14RlZUcN4yLbvnZAWaq1YLen1EXuV8A1WjtXpJjphSgoPUK7L5nnw7JLRlSb4Jswt3wS04NXbE_dSnkEuwucGcow1YvGt-hjI2Y9iMTYmloqPHqU4sVgcbc6nwUIUV2TUP1q_JiwGn7N_cv8fk6tPFj_Mv7eW3z1_PP162Vigo9dhh6LhDtL0Ta-GlpMq6gUnRUVjXPFJR4H4AFNw7IaRmjimUDKlmvJf8mJwdfHfLeuud9XNJOJldCltMv0zEYP7ezGE0m3hnOs4ZZbwanN4bpHi7-FzMNmTrpwlnH5dsaM87QQVlUNF3_6A3cUlzjWcYQA9SAt8b0gNlU8w5-eHxGApmX6M51GhqjWZfoxFV8_bPFI-Kh94qwA5Arqt549PT1_93_Q3sO6mh</recordid><startdate>20170301</startdate><enddate>20170301</enddate><creator>Schousboe, J. T.</creator><creator>Paudel, M. L.</creator><creator>Taylor, B. C.</creator><creator>Kats, A. M.</creator><creator>Virnig, B. A.</creator><creator>Dowd, B. E.</creator><creator>Langsetmo, L.</creator><creator>Ensrud, K. E.</creator><general>Springer London</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170301</creationdate><title>Pre-fracture individual characteristics associated with high total health care costs after hip fracture</title><author>Schousboe, J. T. ; Paudel, M. L. ; Taylor, B. C. ; Kats, A. M. ; Virnig, B. A. ; Dowd, B. E. ; Langsetmo, L. ; Ensrud, K. E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-94ff53daac8d4b4e6617cdf264510b09367103ef0a43ed44692d27a62a1923863</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Body Mass Index</topic><topic>Comorbidity</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Femur Neck - physiopathology</topic><topic>Fractures</topic><topic>Generalized linear models</topic><topic>Health Care Costs - statistics & numerical data</topic><topic>Health care policy</topic><topic>Hip</topic><topic>Hip Fractures - complications</topic><topic>Hip Fractures - economics</topic><topic>Hip Fractures - epidemiology</topic><topic>Hip Fractures - therapy</topic><topic>Hip joint</topic><topic>Hospital Costs - statistics & numerical data</topic><topic>Humans</topic><topic>Medicare</topic><topic>Medicare - economics</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mobility Limitation</topic><topic>Multimorbidity</topic><topic>Nursing</topic><topic>Obesity</topic><topic>Obesity - complications</topic><topic>Obesity - economics</topic><topic>Obesity - epidemiology</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Osteoporosis</topic><topic>Osteoporotic Fractures - complications</topic><topic>Osteoporotic Fractures - economics</topic><topic>Osteoporotic Fractures - epidemiology</topic><topic>Osteoporotic Fractures - therapy</topic><topic>Population studies</topic><topic>Rehabilitation</topic><topic>Rheumatology</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schousboe, J. T.</creatorcontrib><creatorcontrib>Paudel, M. L.</creatorcontrib><creatorcontrib>Taylor, B. C.</creatorcontrib><creatorcontrib>Kats, A. M.</creatorcontrib><creatorcontrib>Virnig, B. A.</creatorcontrib><creatorcontrib>Dowd, B. E.</creatorcontrib><creatorcontrib>Langsetmo, L.</creatorcontrib><creatorcontrib>Ensrud, K. E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Osteoporosis international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schousboe, J. T.</au><au>Paudel, M. L.</au><au>Taylor, B. C.</au><au>Kats, A. M.</au><au>Virnig, B. A.</au><au>Dowd, B. E.</au><au>Langsetmo, L.</au><au>Ensrud, K. E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pre-fracture individual characteristics associated with high total health care costs after hip fracture</atitle><jtitle>Osteoporosis international</jtitle><stitle>Osteoporos Int</stitle><addtitle>Osteoporos Int</addtitle><date>2017-03-01</date><risdate>2017</risdate><volume>28</volume><issue>3</issue><spage>889</spage><epage>899</epage><pages>889-899</pages><issn>0937-941X</issn><eissn>1433-2965</eissn><abstract>Summary
Older women with pre-fracture slow walk speed, high body mass index, and/or a high level of multimorbidity have significantly higher health care costs after hip fracture compared to those without those characteristics. Studies to investigate if targeted health care interventions for these individuals can reduce hip fracture costs are warranted.
Introduction
The aim of this study is to estimate the associations of individual pre-fracture characteristics with total health care costs after hip fracture, using Study of Osteoporotic Fractures (SOF) cohort data linked to Medicare claims.
Methods
Our study population was 738 women age 70 and older enrolled in Medicare Fee for Service (FFS) who experienced an incident hip fracture between January 1, 1992 and December 31, 2009. We assessed pre-fracture individual characteristics at SOF study visits and estimated costs of hospitalizations, skilled nursing facility and inpatient rehabilitation stays, home health care visits, and outpatient utilization from Medicare FFS claims. We used generalized linear models to estimate the associations of predictor variables with total health care costs (2010 US dollars) after hip fracture.
Results
Median total health care costs for 1 year after hip fracture were $35,536 (inter-quartile range $24,830 to $50,903). Multivariable-adjusted total health care costs for 1 year after hip fracture were 14 % higher ($5256, 95 % CI $156 to $10,356) in those with walk speed <0.6 m/s compared to ≥1.0 m/s, 25 % higher ($9601, 95 % CI $3314 to $16,069) in those with body mass index ≥30 kg/m
2
compared to 20 to 24.9 mg/kg
2
, and 21 % higher ($7936, 95 % CI $346 to $15,526) for those with seven or more compared to no comorbid medical conditions.
Conclusions
Pre-fracture poor mobility, obesity, and multiple comorbidities are associated with higher total health care costs after hip fracture in older women. Studies to investigate if targeted health care interventions for these individuals can reduce the costs of hip fractures are warranted.</abstract><cop>London</cop><pub>Springer London</pub><pmid>27743069</pmid><doi>10.1007/s00198-016-3803-4</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Osteoporosis international, 2017-03, Vol.28 (3), p.889-899 |
| issn | 0937-941X 1433-2965 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Aged Aged, 80 and over Body Mass Index Comorbidity Endocrinology Female Femur Neck - physiopathology Fractures Generalized linear models Health Care Costs - statistics & numerical data Health care policy Hip Hip Fractures - complications Hip Fractures - economics Hip Fractures - epidemiology Hip Fractures - therapy Hip joint Hospital Costs - statistics & numerical data Humans Medicare Medicare - economics Medicine Medicine & Public Health Mobility Limitation Multimorbidity Nursing Obesity Obesity - complications Obesity - economics Obesity - epidemiology Original Article Orthopedics Osteoporosis Osteoporotic Fractures - complications Osteoporotic Fractures - economics Osteoporotic Fractures - epidemiology Osteoporotic Fractures - therapy Population studies Rehabilitation Rheumatology United States - epidemiology |
| title | Pre-fracture individual characteristics associated with high total health care costs after hip fracture |
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