J T Schousboe1,2, M L Paudel3, B C Taylor3,4,5, A M Kats3, B A Virnig6, B E Dowd6, L Langsetmo3, K E Ensrud3,4,5. 1. Park Nicollet Clinic and HealthPartners Institute, HealthPartners, 3800 Park Nicollet Blvd, Minneapolis, MN, 55416, USA. schouj@parknicollet.com. 2. Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA. schouj@parknicollet.com. 3. Division of Epidemiology, University of Minnesota, Minneapolis, MN, USA. 4. Center for Chronic Diseases Outcomes Research, Minneapolis VAMC, Minneapolis, MN, USA. 5. Department of Medicine, University of Minnesota, Minneapolis, MN, USA. 6. Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA.
Abstract
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/m2 compared to 20 to 24.9 mg/kg2, 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.
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/m2 compared to 20 to 24.9 mg/kg2, 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.
Entities:
Keywords:
Hip fracture costs; Multimorbidity; Obesity; Total health care costs; Walk speed
Authors: Juliet E Compston; Nelson B Watts; Roland Chapurlat; Cyrus Cooper; Steven Boonen; Susan Greenspan; Johannes Pfeilschifter; Stuart Silverman; Adolfo Díez-Pérez; Robert Lindsay; Kenneth G Saag; J Coen Netelenbos; Stephen Gehlbach; Frederick H Hooven; Julie Flahive; Jonathan D Adachi; Maurizio Rossini; Andrea Z Lacroix; Christian Roux; Philip N Sambrook; Ethel S Siris Journal: Am J Med Date: 2011-11 Impact factor: 4.965
Authors: Russel Burge; Bess Dawson-Hughes; Daniel H Solomon; John B Wong; Alison King; Anna Tosteson Journal: J Bone Miner Res Date: 2007-03 Impact factor: 6.741
Authors: Deborah A Taira; Todd B Seto; Richard Siegrist; Roberta Cosgrove; Ronna Berezin; David J Cohen Journal: Am Heart J Date: 2003-03 Impact factor: 4.749
Authors: John T Schousboe; Misti L Paudel; Brent C Taylor; Lih-Wen Mau; Beth A Virnig; Kristine E Ensrud; Bryan E Dowd Journal: Health Serv Res Date: 2014-01-24 Impact factor: 3.402
Authors: J T Schousboe; M L Paudel; B C Taylor; B A Virnig; J A Cauley; J R Curtis; K E Ensrud Journal: Osteoporos Int Date: 2012-12-04 Impact factor: 4.507
Authors: Jennifer T Lloyd; Shari R Waldstein; Marc C Hochberg; Denise L Orwig; Dawn E Alley Journal: J Gen Intern Med Date: 2019-11 Impact factor: 5.128
Authors: John T Schousboe; Tien N Vo; Lisa Langsetmo; Selcuk Adabag; Pawel Szulc; Joshua R Lewis; Allyson M Kats; Brent C Taylor; Kristine E Ensrud Journal: Atherosclerosis Date: 2020-01-19 Impact factor: 5.162
Authors: Kristine E Ensrud; Allyson M Kats; John T Schousboe; Brent C Taylor; Peggy M Cawthon; Teresa A Hillier; Kristine Yaffe; Steve R Cummings; Jane A Cauley; Lisa Langsetmo Journal: J Am Geriatr Soc Date: 2018-04-23 Impact factor: 5.562
Authors: John T Schousboe; Tien N Vo; Allyson M Kats; Lisa Langsetmo; Susan J Diem; Brent C Taylor; Elsa S Strotmeyer; Kristine E Ensrud Journal: J Am Geriatr Soc Date: 2019-03-23 Impact factor: 5.562
Authors: Kristine E Ensrud; Allyson M Kats; John T Schousboe; Lisa Langsetmo; Tien N Vo; Terri L Blackwell; Daniel J Buysse; Sonia Ancoli-Israel; Katie L Stone Journal: Sleep Date: 2020-02-13 Impact factor: 5.849
Authors: Tien N Vo; Allyson M Kats; Lisa Langsetmo; Brent C Taylor; John T Schousboe; Susan Redline; Ken M Kunisaki; Katie L Stone; Kristine E Ensrud Journal: Sleep Date: 2020-01-13 Impact factor: 5.849
Authors: Kristine E Ensrud; Allyson M Kats; John T Schousboe; Brent C Taylor; Tien N Vo; Peggy M Cawthon; Andrew R Hoffman; Lisa Langsetmo Journal: J Am Geriatr Soc Date: 2020-05-13 Impact factor: 5.562
Authors: John T Schousboe; Allyson M Kats; Katie L Stone; Lisa Langsetmo; Tien N Vo; Terri L Blackwell; Daniel J Buysse; Sonia Ancoli-Israel; Kristine E Ensrud Journal: Sleep Date: 2020-10-13 Impact factor: 5.849