美国骨质疏松症患者后继非椎骨骨折的患病率和费用。

Prevalence and costs of osteoporotic patients with subsequent non-vertebral fractures in the US.

机构信息

Analysis Group, Inc., 111 Huntington Avenue, 10th Floor, Boston, MA 02199, USA.

出版信息

Osteoporos Int. 2011 Oct;22(10):2611-21. doi: 10.1007/s00198-010-1494-9. Epub 2010 Nov 25.

DOI:10.1007/s00198-010-1494-9

PMID:21107532

Abstract

UNLABELLED

This study assesses prevalence of subsequent fractures during the year after incident osteoporosis-related non-vertebral fractures among privately insured and Medicare populations and compares costs between patients with and without subsequent fractures. Many non-vertebral fracture patients incur subsequent fractures, and those who do are significantly more costly during the year after incident fracture.

INTRODUCTION

To estimate the prevalence of subsequent osteoporosis-related non-vertebral (NV) fractures during the year following an incident NV fracture and compare costs between NV fracture patients with and without subsequent fractures.

METHODS

Using insurance claims data (1999-2006), privately-insured (ages 18-64 years) and Medicare (ages 65+ years) patients with ≥1 subsequent osteoporosis-related NV fracture within a year of an incident osteoporosis-related NV fracture were matched to controls with incident NV fractures but no subsequent fractures. Subsequent fractures were identified as any claim for an NV fracture occurring >3 months after the incident NV fracture (>6 months were required for fractures occurring at the same site as the incident fracture). The study assessed prevalence of subsequent fractures and compared costs (from the payer's perspective) between patients with and without subsequent fractures over the year following an incident NV fracture.

RESULTS

Among privately insured NV fracture patients, 14.1% had any subsequent NV fractures, 1.6% had subsequent hip fractures, and 13.0% had subsequent non-vertebral, non-hip (NVNH) fractures, while 22.6% of Medicare NV fracture patients had subsequent NV fractures, 9.4% had subsequent hip fractures, and 15.5% had subsequent NVNH fractures. Mean excess health care costs per privately insured subsequent fracture patient were $9,789 ($19,072 vs. $9,914, p < 0.01), while excess medical costs per Medicare subsequent fracture patient were $12,527 ($31,904 vs. $19,377, p < 0.01).

CONCLUSIONS

NV fracture patients are at substantial risk for subsequent NV fractures within 1 year, and patients who incur subsequent fractures are significantly more costly than those who do not during the year following an incident fracture.

摘要

目的

评估在骨质疏松性非椎体骨折发生后 1 年内，私人保险和医疗保险患者中随后发生骨折的发生率，并比较有和无随后骨折患者之间的成本。

方法

使用保险索赔数据（1999-2006 年），对 1 年内至少有 1 次后续骨质疏松性非椎体（NV）骨折的私人保险（年龄 18-64 岁）和医疗保险（年龄 65 岁以上）患者进行分析，将他们与仅有初次 NV 骨折但无后续骨折的对照者进行匹配。将后续骨折定义为初次 NV 骨折后 3 个月以上（对于与初次骨折部位相同的骨折，需要 6 个月以上）发生的任何 NV 骨折索赔。研究评估了随后骨折的发生率，并比较了在初次 NV 骨折发生后 1 年内，有和无随后骨折患者的成本（从支付者的角度来看）。

结果

在私人保险 NV 骨折患者中，14.1%有任何后续 NV 骨折，1.6%有后续髋部骨折，13.0%有后续非椎体、非髋部（NVNH）骨折，而在医疗保险 NV 骨折患者中，22.6%有后续 NV 骨折，9.4%有后续髋部骨折，15.5%有后续 NVNH 骨折。每例私人保险后续骨折患者的平均超额医疗保健费用为 9789 美元（9914 美元与 9914 美元相比，p<0.01），而每例医疗保险后续骨折患者的超额医疗费用为 12527 美元（31904 美元与 19377 美元相比，p<0.01）。