Unrecognized risks among Veterans with hip fractures: opportunities for improvements

Hip fractures are associated with significant morbidity and mortality. Most of these fractures are preventable late manifestations of osteoporosis. The authors examined incidence and medical costs associated with hip fractures among 34,363 veterans by gender and race for fiscal years 1996-2000. Data were obtained from the Patient Treatment File administrative database. The frequencies of seven known risk factors were quantified. White veterans hospitalized for hip fracture were 69% more likely to be given the diagnosis of osteoporosis, when compared to black veterans. Male gender was associated with lower percentage of osteoporosis diagnoses (2.2%) than female gender (11.9%). The authors estimate that hip fractures result in 43 million dollars of excess cost to veterans and the Veterans Health Administration annually. Greater use of diagnostic and preventive measures represents an excellent opportunity for improvement of care, as well as substantial cost savings for at risk populations.