BACKGROUND: Ethnic disparities in care have been documented with a number of musculoskeletal disorders including osteoporosis. We suggest a systems approach for ensuring osteoporosis care can minimize potential ethnic disparities in care. QUESTIONS/PURPOSES: We evaluated variations in osteoporosis treatment by age, sex, and race/ethnicity by (1) measuring the rates of patients after a fragility fracture who had been evaluated by dual-energy xray absorptiometry and/or in whom antiosteoporosis treatment had been initiated and (2) determining the rates of osteoporosis treatment in patients who subsequently had a hip fracture. PATIENTS AND METHODS: We implemented an integrated osteoporosis prevention program in a large health plan. Continuous screening of electronic medical records identified patients who met the criteria for screening for osteoporosis, were diagnosed with osteoporosis, or sustained a fragility fracture. At-risk patients were referred to care managers and providers to complete practice guidelines to close care gaps. Race/ethnicity was self-reported. Treatment rates after fragility fracture or osteoporosis treatment failures with later hip fracture were calculated. Data for the years 2008 to 2009 were stratified by age, sex, and race/ethnicity. RESULTS: Women (92.1%) were treated more often than men (75.2%) after index fragility fracture. The treatment rate after fragility fracture was similar among race/ethnic groups in either sex (women 87.4%-93.4% and men 69.3%-76.7%). Osteoporotic treatment before hip fracture was more likely in white men and women and Hispanic men than other race/ethnic and gender groups. CONCLUSIONS: Racial variation in osteoporosis care after fragility fracture in race/ethnic groups in this healthcare system was low when using the electronic medical record identifying care gaps, with continued reminders to osteoporosis disease management care managers and providers until those care gaps were closed.
BACKGROUND: Ethnic disparities in care have been documented with a number of musculoskeletal disorders including osteoporosis. We suggest a systems approach for ensuring osteoporosis care can minimize potential ethnic disparities in care. QUESTIONS/PURPOSES: We evaluated variations in osteoporosis treatment by age, sex, and race/ethnicity by (1) measuring the rates of patients after a fragility fracture who had been evaluated by dual-energy xray absorptiometry and/or in whom antiosteoporosis treatment had been initiated and (2) determining the rates of osteoporosis treatment in patients who subsequently had a hip fracture. PATIENTS AND METHODS: We implemented an integrated osteoporosis prevention program in a large health plan. Continuous screening of electronic medical records identified patients who met the criteria for screening for osteoporosis, were diagnosed with osteoporosis, or sustained a fragility fracture. At-risk patients were referred to care managers and providers to complete practice guidelines to close care gaps. Race/ethnicity was self-reported. Treatment rates after fragility fracture or osteoporosis treatment failures with later hip fracture were calculated. Data for the years 2008 to 2009 were stratified by age, sex, and race/ethnicity. RESULTS:Women (92.1%) were treated more often than men (75.2%) after index fragility fracture. The treatment rate after fragility fracture was similar among race/ethnic groups in either sex (women 87.4%-93.4% and men 69.3%-76.7%). Osteoporotic treatment before hip fracture was more likely in white men and women and Hispanic men than other race/ethnic and gender groups. CONCLUSIONS: Racial variation in osteoporosis care after fragility fracture in race/ethnic groups in this healthcare system was low when using the electronic medical record identifying care gaps, with continued reminders to osteoporosis disease management care managers and providers until those care gaps were closed.
Authors: Dorothy D Dunlop; Larry M Manheim; Jing Song; Min-Woong Sohn; Joseph M Feinglass; Huan J Chang; Rowland W Chang Journal: Med Care Date: 2008-02 Impact factor: 2.983
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Authors: Jane A Cauley; Lieling Wu; Nina S Wampler; Janice M Barnhart; Matthew Allison; Zhao Chen; Rebecca Jackson; John Robbins Journal: J Bone Miner Res Date: 2007-11 Impact factor: 6.741
Authors: Jeffrey R Curtis; Leslie A McClure; Elizabeth Delzell; Virginia J Howard; Eric Orwoll; Kenneth G Saag; Monika Safford; George Howard Journal: J Gen Intern Med Date: 2009-06-24 Impact factor: 5.128
Authors: Nicole C Wright; Mary E Melton; Maira Sohail; Ivan Herbey; Susan Davies; Emily B Levitan; Kenneth G Saag; Natalia V Ivankova Journal: J Racial Ethn Health Disparities Date: 2019-02-11
Authors: K Ganda; M Puech; J S Chen; R Speerin; J Bleasel; J R Center; J A Eisman; L March; M J Seibel Journal: Osteoporos Int Date: 2012-07-25 Impact factor: 4.507