Isolating the cost of osteoporosis-related fracture for postmenopausal women - A population-based study

Background: Osteoporosis is a condition that will pose an increasing burden on health systems as populations age. Objective: The objective of this stu dy was to estimate the net 'per case' direct medical cost of fracture of in digent women age 50 years or greater and describe the cost of fracture for Medicaid and Medicare payers by inpatient hospital, physician, long-term ca re, prescription and miscellaneous expenditures. Methods: This study utiliz ed a quasi-experimental retrospective interrupted time series design to iso late the economic impact of fracture. Administrative claims data for a cont inuous period of 24 months (12 months prior to fracture and 12 months after fracture) describing the Medicaid and Medicare expenditures for a cohort o f women suffering from femur or other fracture in 1993 was abstracted and a nalyzed. ICD-9CM and CPT-4 codes were used to identify incident cases of fr acture. Interrupted ti me series regression models were estimated using mon thly expenditures. Results: A total of 765 Medicaid eligible women 50 yea r s of age or greater experienced a fracture in the base year and met inclusi on criteria. Of these, 226 experienced a femur fracture. The time series mo dels detected significant increases in expenditures the month of fracture, however, total Medicaid expenditures returned to baseline trend charge in 7 and 5 months for femur and nonfemur fracture, respectively. Increases in l ong-term care expenditures persisted throughout the time series, but were o ffset by reductions in other categories of service. Conclusion: The net per case costs of femur and nonfemur fracture are about USD 3,300 and USD 1,30 0, respectively. The impact of fracture on Medicaid expenditures is tempora ry as costs rise sharply and return to baseline trend charges within a 12-m onth period. Copyright (C) 2001 S. Karger AG,Basel.