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Erschienen in: Osteoporosis International 3/2013

01.03.2013 | Original Article

Cost and management of males with closed fractures

verfasst von: S. K. Brenneman, N. Yurgin, Y. Fan

Erschienen in: Osteoporosis International | Ausgabe 3/2013

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Abstract

Summary

The purpose of this study was to examine the medical costs and the management of osteoporosis in the 12 months after a closed fracture for men aged ≥ 45 years. The mean medical cost per fracture was high ($6,078–$30,900), and osteoporosis management post fracture was inadequate in the majority of men.

Introduction

This study was conducted in order to examine the medical costs following fracture in males and the management of osteoporosis post fracture.

Methods

Administrative claims from a large, national health plan were analyzed. Men ≥ 45 years were included if they had ≥ 1 medical claim for a new closed fracture between January 1, 2005 and December 31, 2008. Commercially insured (COM) and Medicare Advantage Plan (MAP) members were analyzed separately. Costs were calculated as paid amounts and adjusted to 2010 dollars. Both the differences between the individual patients’ 12-month pre-fracture and 12-month post-fracture costs and the costs directly attributed to the fracture were reported. The prevalence of dual-energy X-ray absorptiometry (DXA) scan and/or osteoporosis pharmacotherapy treatment was evaluated in the 12 months post fracture.

Results

We identified 18,917 (COM, 16,191; MAP, 2,726) men with new closed fractures. Non-hip, non-vertebral fractures (NHNV) were the most common fracture in both COM and MAP populations. Fracture costs ranged from $7,121 to $15,830 for vertebral fractures, from $22,601 to $30,900 for hip fractures, and from $6,078 to $8,344 for NHNV fractures. In the COM and MAP populations, respectively, 8.5 and 15.5 % had a DXA scan and/or osteoporosis pharmacotherapy in the 12 months following the fracture.

Conclusions

Healthcare costs associated with fractures in men are substantial. About 1 in 12 men ≥ 45 years in the COM population were provided adequate follow-up for osteoporosis post fracture. While this rate improved to about one in six men in the MAP population, osteoporosis management in men post fracture is far from optimal.
Literatur
2.
Zurück zum Zitat Nguyen ND, Eisman JA, Center JR, Nguyen TV (2007) Risk factors for fracture in nonosteoporotic men and women. J Clin Endocrinol Metab 92(3):955–962CrossRefPubMed Nguyen ND, Eisman JA, Center JR, Nguyen TV (2007) Risk factors for fracture in nonosteoporotic men and women. J Clin Endocrinol Metab 92(3):955–962CrossRefPubMed
3.
Zurück zum Zitat Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22(3):465–475CrossRefPubMed Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22(3):465–475CrossRefPubMed
4.
Zurück zum Zitat King AB, Tosteson AN, Wong JB, Solomon DH, Burge RT, Dawson-Hughes B (2009) Interstate variation in the burden of fragility fractures. J Bone Miner Res 24(4):681–692CrossRefPubMed King AB, Tosteson AN, Wong JB, Solomon DH, Burge RT, Dawson-Hughes B (2009) Interstate variation in the burden of fragility fractures. J Bone Miner Res 24(4):681–692CrossRefPubMed
5.
Zurück zum Zitat Bass E, French DD, Bradham DD (2008) A national perspective of Medicare expenditures for elderly veterans with hip fractures. J Am Med Dir Assoc 9(2):114–119CrossRefPubMed Bass E, French DD, Bradham DD (2008) A national perspective of Medicare expenditures for elderly veterans with hip fractures. J Am Med Dir Assoc 9(2):114–119CrossRefPubMed
6.
Zurück zum Zitat Fransen M, Woodward M, Norton R, Robinson E, Butler M, Campbell AJ (2002) Excess mortality or institutionalization after hip fracture: men are at greater risk than women. J Am Geriatr Soc 50(4):685–690CrossRefPubMed Fransen M, Woodward M, Norton R, Robinson E, Butler M, Campbell AJ (2002) Excess mortality or institutionalization after hip fracture: men are at greater risk than women. J Am Geriatr Soc 50(4):685–690CrossRefPubMed
7.
Zurück zum Zitat Haentjens P, Magaziner J, Colon-Emeric CS, Vanderschueren D, Milisen K, Velkeniers B, Boonen S (2010) Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med 152(6):380–390PubMed Haentjens P, Magaziner J, Colon-Emeric CS, Vanderschueren D, Milisen K, Velkeniers B, Boonen S (2010) Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med 152(6):380–390PubMed
8.
Zurück zum Zitat Szulc P, Kaufman JM, Orwoll ES (2012) Osteoporosis in men. J Osteoporos 2012:675984PubMed Szulc P, Kaufman JM, Orwoll ES (2012) Osteoporosis in men. J Osteoporos 2012:675984PubMed
9.
Zurück zum Zitat Kiebzak GM, Beinart GA, Perser K, Ambrose CG, Siff SJ, Heggeness MH (2002) Undertreatment of osteoporosis in men with hip fracture. Arch Intern Med 162(19):2217–2222CrossRefPubMed Kiebzak GM, Beinart GA, Perser K, Ambrose CG, Siff SJ, Heggeness MH (2002) Undertreatment of osteoporosis in men with hip fracture. Arch Intern Med 162(19):2217–2222CrossRefPubMed
10.
Zurück zum Zitat Morris CA, Cabral D, Cheng H, Katz JN, Finkelstein JS, Avorn J, Solomon DH (2004) Patterns of bone mineral density testing: current guidelines, testing rates, and interventions. J Gen Intern Med 19(7):783–790CrossRefPubMed Morris CA, Cabral D, Cheng H, Katz JN, Finkelstein JS, Avorn J, Solomon DH (2004) Patterns of bone mineral density testing: current guidelines, testing rates, and interventions. J Gen Intern Med 19(7):783–790CrossRefPubMed
11.
Zurück zum Zitat Follin SL, Black JN, McDermott MT (2003) Lack of diagnosis and treatment of osteoporosis in men and women after hip fracture. Pharmacotherapy 23(2):190–198CrossRefPubMed Follin SL, Black JN, McDermott MT (2003) Lack of diagnosis and treatment of osteoporosis in men and women after hip fracture. Pharmacotherapy 23(2):190–198CrossRefPubMed
12.
Zurück zum Zitat Solomon DH, Morris C, Cheng H, Cabral D, Katz JN, Finkelstein JS, Avorn J (2005) Medication use patterns for osteoporosis: an assessment of guidelines, treatment rates, and quality improvement interventions. Mayo Clin Proc 80(2):194–202CrossRefPubMed Solomon DH, Morris C, Cheng H, Cabral D, Katz JN, Finkelstein JS, Avorn J (2005) Medication use patterns for osteoporosis: an assessment of guidelines, treatment rates, and quality improvement interventions. Mayo Clin Proc 80(2):194–202CrossRefPubMed
13.
Zurück zum Zitat Cadarette SM, Katz JN, Brookhart MA, Levin R, Stedman MR, Choudhry NK, Solomon DH (2008) Trends in drug prescribing for osteoporosis after hip fracture, 1995–2004. J Rheumatol 35(2):319–326PubMed Cadarette SM, Katz JN, Brookhart MA, Levin R, Stedman MR, Choudhry NK, Solomon DH (2008) Trends in drug prescribing for osteoporosis after hip fracture, 1995–2004. J Rheumatol 35(2):319–326PubMed
14.
Zurück zum Zitat Diamond T, Sambrook P, Williamson M, Flicker L, Nowson C, Fiatarone-Singh M, Lord S, Ferris L, O'Neil S, MacLennan A (2001) Guidelines for treatment of osteoporosis in men. Aust Fam Physician 30(8):787–791PubMed Diamond T, Sambrook P, Williamson M, Flicker L, Nowson C, Fiatarone-Singh M, Lord S, Ferris L, O'Neil S, MacLennan A (2001) Guidelines for treatment of osteoporosis in men. Aust Fam Physician 30(8):787–791PubMed
17.
Zurück zum Zitat Christensen L, Iqbal S, Macarios D, Badamgarav E, Harley C (2010) Cost of fractures commonly associated with osteoporosis in a managed-care population. J Med Econ 13(2):302–313CrossRefPubMed Christensen L, Iqbal S, Macarios D, Badamgarav E, Harley C (2010) Cost of fractures commonly associated with osteoporosis in a managed-care population. J Med Econ 13(2):302–313CrossRefPubMed
18.
Zurück zum Zitat Huybrechts KF, Ishak KJ, Caro JJ (2006) Assessment of compliance with osteoporosis treatment and its consequences in a managed care population. Bone 38(6):922–928CrossRefPubMed Huybrechts KF, Ishak KJ, Caro JJ (2006) Assessment of compliance with osteoporosis treatment and its consequences in a managed care population. Bone 38(6):922–928CrossRefPubMed
19.
Zurück zum Zitat Weycker D, Macarios D, Edelsberg J, Oster G (2007) Compliance with osteoporosis drug therapy and risk of fracture. Osteoporos Int 18(3):271–277CrossRefPubMed Weycker D, Macarios D, Edelsberg J, Oster G (2007) Compliance with osteoporosis drug therapy and risk of fracture. Osteoporos Int 18(3):271–277CrossRefPubMed
20.
Zurück zum Zitat Weycker D, Macarios D, Edelsberg J, Oster G (2006) Compliance with drug therapy for postmenopausal osteoporosis. Osteoporos Int 17(11):1645–1652CrossRefPubMed Weycker D, Macarios D, Edelsberg J, Oster G (2006) Compliance with drug therapy for postmenopausal osteoporosis. Osteoporos Int 17(11):1645–1652CrossRefPubMed
21.
Zurück zum Zitat Kilgore ML, Morrisey MA, Becker DJ, Gary LC, Curtis JR, Saag KG, Yun H, Matthews R, Smith W, Taylor A et al (2009) Health care expenditures associated with skeletal fractures among Medicare beneficiaries, 1999–2005. J Bone Miner Res 24(12):2050–2055CrossRefPubMed Kilgore ML, Morrisey MA, Becker DJ, Gary LC, Curtis JR, Saag KG, Yun H, Matthews R, Smith W, Taylor A et al (2009) Health care expenditures associated with skeletal fractures among Medicare beneficiaries, 1999–2005. J Bone Miner Res 24(12):2050–2055CrossRefPubMed
23.
Zurück zum Zitat Frytak JR, Henk HJ, Zhao Y, Bowman L, Flynn JA, Nelson M (2008) Health service utilization among Alzheimer's disease patients: evidence from managed care. Alzheimers Dement 4(5):361–367CrossRefPubMed Frytak JR, Henk HJ, Zhao Y, Bowman L, Flynn JA, Nelson M (2008) Health service utilization among Alzheimer's disease patients: evidence from managed care. Alzheimers Dement 4(5):361–367CrossRefPubMed
24.
25.
Zurück zum Zitat Binkley N (2009) A perspective on male osteoporosis. Best Pract Res Clin Rheumatol 23(6):755–768CrossRefPubMed Binkley N (2009) A perspective on male osteoporosis. Best Pract Res Clin Rheumatol 23(6):755–768CrossRefPubMed
26.
Zurück zum Zitat Ohsfeldt RL, Borisov NN, Sheer RL (2006) Fragility fracture-related direct medical costs in the first year following a nonvertebral fracture in a managed care setting. Osteoporos Int 17(2):252–258CrossRefPubMed Ohsfeldt RL, Borisov NN, Sheer RL (2006) Fragility fracture-related direct medical costs in the first year following a nonvertebral fracture in a managed care setting. Osteoporos Int 17(2):252–258CrossRefPubMed
Metadaten
Titel
Cost and management of males with closed fractures
verfasst von
S. K. Brenneman
N. Yurgin
Y. Fan
Publikationsdatum
01.03.2013
Verlag
Springer-Verlag
Erschienen in
Osteoporosis International / Ausgabe 3/2013
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-012-2067-x

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