Health Care Expenditures Associated With Skeletal Fractures Among Medicare Beneficiaries, 1999–2005

Abstract

Fractures impose substantial burdens, in terms of both costs and health, on individuals and health care systems. This is particularly true for older Americans and the Medicare system. The objective of this study was to estimate the costs of care associated with selected fractures among Medicare beneficiaries. This was a retrospective, person-level, pre/postfracture analysis using administrative data. The study used Medicare claims data from 1999 through 2005 for a 5% sample of Medicare beneficiaries. The subjects included Medicare beneficiaries, 65 yr of age, who had at least 13 mo of both Parts A and B coverage and not enrolled in Medicare Advantage and who experienced a closed fracture of the hip, femur, pelvis, tibia/ fibula, ankle, distal forearm, nondistal radius/ulna, humerus, clavicle, spine, or wrist, or any fracture of the distal forearm or ankle during the years 2000 through 2005. The main outcome measures were incremental (greater than baseline) and attributable (directly associated) payments for Medicare-covered services for the first 6 mo after incident fractures. Incremental payments ranged from $7788 (95% CI, $7550-$8025) for distal forearm fractures to $31,310 (95% CI, $31,073-$31,547) for open hip fractures; the attributable payments for distal forearm and hip fractures were $1856 and $18,734, respectively. Fractures are associated with substantial increases in health services utilization and costs among Medicare beneficiaries, but significant proportions of those costs are not directly attributable to fracture treatment. Further research is needed to ascertain other health conditions that are driving costs for Medicare beneficiaries after fractures.

Prescription patterns of Chinese herbal products for patients with fractures in Taiwan: A nationwide population-based study

“…In summary, these herbs can promote bone healing, prevent bone loss, relieve pain, reduce inflammation and promote circulation. A previous study analyzing Medicare claims data in the United States found that fractures are associated with substantial increases in health services utilization and costs for the first 6 months after the occurrence of fractures (Kilgore et al, 2009). Another study using the Population Health Research Data Repository for Manitoba, Canada also found that there are large incremental health care costs associated with incident fractures in Canada (Leslie et al, 2011).…”

A Guide to Improving the Care of Patients with Fragility Fractures, Edition 2

“…273 Care of the patient with a distal radius fracture is also costly: A cost of US$7788 (between years 2000 and 2005) has been estimated for a Medicare patient with a distal radius fracture. 274 Despite their frequency, treatment of distal radius fractures in elderly patients is controversial 275 …”

Epidemiology of distal radius fractures and factors predicting risk and prognosis

“…[1][2][3][4][5] Recent data from a cohort of 208,094 patients from the United States revealed that the radius was the most common long bone to fracture. 6 DRF accounts for one-sixth of all emergency department visits 6,7 and 26%-46% of all skeletal fractures observed in the primary care setting. [8][9][10][11][12][13] Typically, a DRF is characterized by a low-energy fracture occurring approximately 2 cm above the distal articular surface of the radius at the junction where the cortical bone becomes thinner and is reinforced by the trabecular bone network.…”