VA Boston Healthcare System & Beth Israel Deaconess Medical Center, Department of Medicine, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA.
Hebrew SeniorLife, Institute of Aging Research & Beth Israel Deaconess Medical Center, Department of Medicine, Harvard Medical School, 1200 Centre Street, Boston, MA 02131, USA.
Bone. 2019 Jun;123:204-210. doi: 10.1016/j.bone.2019.04.001. Epub 2019 Apr 3.
To compare the standardized incidence rates (IRs) of hip fracture for Native Americans versus other racial groups in U.S. nursing homes (NHs).
We studied Medicare fee-for-service NH residents aged ≥65 years who became long-stay (index date) between 1/1/2008 and 12/31/2009 (n = 1,136,544). Residents were followed from the index date until occurrence of hip fracture, death, Medicare disenrollment, or study end (12/31/2013). We calculated hip fracture IRs by race and used inverse probability weighting to standardize the rates for baseline demographic and clinical characteristics collected from the Minimum Data Set and Medicare claims data. We compared characteristics of NHs used by residents of different races using Online Survey, Certification and Reporting (OSCAR) data.
Among long-stay U.S. NH residents, the standardized IR of hip fracture per 100 person-years was highest in Native Americans [2.16; 95% confidence interval (CI) 1.91-2.44] and white residents (2.05; 2.03-2.06), and lowest in black residents (0.82; 0.79-0.85). NHs caring for Native American residents were more likely to be rurally located as compared to other racial group.
In U.S. NHs, Native Americans and whites have the highest standardized IR of hip fracture and should receive particular attention in fracture prevention efforts.
比较美国养老院（NH）中美国原住民与其他种族群体的髋部骨折标准化发病率（IR）。
我们研究了参加 Medicare 按服务收费的 NH 居民，年龄≥65 岁，在 2008 年 1 月 1 日至 2009 年 12 月 31 日期间成为长期居住者（索引日期）（n=1136544）。居民从索引日期开始随访，直到发生髋部骨折、死亡、退出 Medicare 或研究结束（2013 年 12 月 31 日）。我们按种族计算髋部骨折的 IR，并使用逆概率加权法对从最低数据集中收集的基线人口统计学和临床特征以及 Medicare 理赔数据进行标准化。我们使用 Online Survey、Certification and Reporting（OSCAR）数据比较了不同种族居民使用的 NH 的特征。
在长期居住的美国 NH 居民中，髋部骨折的标准化发病率（每 100 人年）最高的是美国原住民（2.16；95%置信区间（CI）1.91-2.44）和白人居民（2.05；2.03-2.06），最低的是黑人居民（0.82；0.79-0.85）。与其他种族群体相比，照顾美国原住民的 NH 更有可能位于农村地区。
在美国 NH 中，美国原住民和白人髋部骨折的标准化发病率最高，应特别关注他们的骨折预防工作。
