Economic burden of osteoporotic fractures in US managed care enrollees
| Autor: | R. Weiss, Yamei Wang, Setareh A. Williams, Sergio Barrera-Sierra, Kevin Sundquist, Deane Leader, Benjamin Chastek, Jeffrey R. Curtis |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Population 030209 endocrinology & metabolism Pharmacy Comorbidity Kaplan-Meier Estimate Medicare Advantage 03 medical and health sciences Insurance Claim Review 0302 clinical medicine Cost of Illness Adrenal Cortex Hormones Health care medicine Humans 030212 general & internal medicine education Aged Retrospective Studies Aged 80 and over education.field_of_study Rehabilitation business.industry Health Policy Managed Care Programs Retrospective cohort study Health Services Middle Aged medicine.disease United States Socioeconomic Factors Emergency medicine Managed care Health Resources Medicare Part C Female Health Expenditures business Osteoporotic Fractures |
| Zdroj: | The American journal of managed care. 26(5) |
| ISSN: | 1936-2692 |
| Popis: | Objectives To examine healthcare resource utilization (HRU) and costs in a population of managed care enrollees who experienced an osteoporotic fracture. Study design Retrospective cohort study using the Optum Research Database (January 2007 to May 2017). Methods All-cause and osteoporosis-related HRU and costs were analyzed in patients 50 years and older with a qualifying index fracture and continuous enrollment with medical and pharmacy benefits for 12 months preindex (baseline period). Results Of 1,841,263 patients with fractures during the identification period, 302,772 met eligibility criteria. Two-thirds (66.6%) were 65 years and older, 71.6% were women, and 41.2% were commercial (not Medicare Advantage) enrollees. The most common fracture sites were spine (21.9%), radius/ulna (19.5%), and hip (13.7%). Mean (SD) total all-cause healthcare cost was $34,855 ($56,094), with most paid by health plans ($31,863 [$55,025]) versus patients ($2992 [$2935]). Most healthcare costs were for medical ($31,766 [$54,943]) versus pharmacy ($3089 [$6799]) services. Approximately 75% of patients received rehabilitation services (mean [SD] cost = $18,025 [$41,318]). Diagnosis of index fracture during an inpatient stay versus an outpatient visit (cost ratio, 2.16; 95% CI, 2.13-2.19) and fractures at multiple sites (cost ratio, 1.23; 95% CI, 1.21-1.26) were the leading predictors of cost. Kaplan-Meier estimated cumulative second-fracture rates were 6.6% at 1 year, 12.3% at 2 years, 16.9% at 3 years, and 20.9% at 4 years after index fracture. Conclusions These findings suggest a significant economic burden associated with fractures, including a high total all-cause cost of care. Early identification and treatment of patients at high risk of fractures are of paramount importance to reduce fracture risk and associated healthcare costs. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|