Osteoporosis and hip fractures in the Medicare population, 1992-1996.

Introduction

Osteoporosis is a major health concern for both males and females. In the United States, osteoporosis affects approximately 20 million people. The focus in recent years has been on females and post-menopausal females, in particular. Current studies have noted that as part of the aging process, males and females lose bone mass resulting in an increase risk of fractures. Over 1.5 million broken bones have been reported with 250,000 of these injuries being fractures of the hip (Scott and Hochberg, 1998; Woodhead and Moss, 1998).

The Medicare Current Beneficiary Survey (MCBS) is a critical resource for determining the burden of diseases and health conditions in the Medicare population. The MCBS is a national household survey of approximately 12,000 Medicare beneficiaries who are disabled (under age 65) or aged (65 or over). The MCBS is designed to identify the sources of payment for services, determine the types of health insurance coverage as well as to monitor health and changes in health status over time (Adler, 1994).

Findings

Data from the MCBS Cost and Use Files for 1992-1996 were used to describe the osteoporosis and hip fracture burden for the Medicare population. Figures 1-7 show the findings across the 5-year period by age, sex, and race/ethnicity. In general, there is an increase in the percentage of osteoporosis reported for all of the years, while the percentage of hip fractures has remained relatively stable over the same timeframe (Figure 1). Females continuously report higher percentages of osteoporosis and broken hips compared with their male counterparts (Figures 2 and 3). Over time, the percentage of osteoporosis increases for the age groups 75-84 and 85 or over with the latter group reporting the largest burden (Figure 4). Moreover, the age group 85 or over was found to have the highest percentages reported for hip fracture as well (Figure 5). The last two figures show the race/ethnicity distributions for osteoporosis and hip fracture. Higher percentages were found for white persons and Hispanics with respect to reporting osteoporosis (Figure 6). In addition, beneficiaries who identified themselves as white reported higher percentages for the broken hip question when compared with the beneficiaries who selected black or Hispanic as their race and/or ethnicity (Figure 7).

Figure 1

Percentage of Osteoporosis and Broken Hip Reported: 1992-1996

Figure 7

Percentage of Beneficiaries Reporting a Broken Hip, by Race and Ethnicity: 1992-1996

Figure 2

Percentage of Beneficiaries Reporting Osteoporosis, by Sex: 1992-1996

Figure 3

Percentage of Beneficiaries Reporting a Broken Hip, by Sex: 1992-1996

Figure 4

Percentage of Beneficiaries Reporting Osteoporosis, by Age Group: 1992-1996

Figure 5

Percentage of Beneficaries Reporting a Broken Hip, by Age Group: 1992-1996

Figure 6

Percentage of Beneficiaries Reporting Osteoporosis, by Race and Ethnicity: 1992-1996