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Published on: November 8, 2024
Cost and management of males with closed fractures
S K Brenneman1, N Yurgin, Y Fan
1OptumInsight, 12525 Technology Drive, Eden Prairie, MN 55344, USA. susan.brenneman@optum.com
Insights
Osteoporosis management after fracture in men over 45 is inadequate, despite high medical costs. Few men receive recommended follow-up care, highlighting a critical gap in post-fracture osteoporosis treatment.
Area of Science:
- Gerontology
- Health Economics
- Orthopedics
Background:
- Fractures in men aged 45 and older incur significant healthcare expenditures.
- Osteoporosis management following fractures in this demographic is often insufficient.
Purpose of the Study:
- To assess the medical costs associated with fractures in men aged 45 years and older.
- To evaluate the adequacy of osteoporosis management in the 12 months following a fracture in this population.
Main Methods:
- Analysis of administrative claims data from a national health plan for men aged 45+ with new closed fractures.
- Calculation of 12-month pre- and post-fracture medical costs, adjusted to 2010 dollars.
- Evaluation of dual-energy X-ray absorptiometry (DXA) scan and osteoporosis pharmacotherapy rates post-fracture.
Main Results:
- Identified 18,917 men with fractures; non-hip, non-vertebral fractures were most common.
- Fracture costs varied significantly, ranging from $6,078 to $30,900.
- Only 8.5% of commercially insured and 15.5% of Medicare Advantage Plan members received DXA scans or osteoporosis medication post-fracture.
Conclusions:
- Fractures in men aged 45+ represent a substantial healthcare cost.
- Osteoporosis follow-up care is inadequate for the majority of men post-fracture.
- While slightly better in Medicare Advantage Plan members, overall osteoporosis management remains suboptimal.
Unlabelled:
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.
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