Characteristics of hip fracture patients with and without muscle atrophy/weakness: Predictors of negative economic outcomes. (January 2015)

• Record Type: Journal Article
• Authors: Cui, Zhanglin; Schoenfeld, Michael J.; Bush, Elizabeth Nicole; Chen, Yi; Burge, Russel
• Is Part Of: Journal of medical economics. Volume 18:Number 1(2015)
• Page Start: 1
• Page End: 11
• Publication Date: 2015-01
• Subjects: Medical care -- Cost control -- Periodicals; Medical economics -- Periodicals; 362.10941
• DOI: 10.3111/13696998.2014.969433
• Languages: English
• ISSNs: 1369-6998

Abstract

<abstract> <title>Abstract</title> <sec id="ss1"> <title>Objective:</title> <p>Hip fractures have negative humanistic and economic consequences. Predictors and sub-groups of negative post-fracture outcomes (high costs and extensive healthcare utilization) were identified in patients with and without muscle atrophy/weakness (MAW).</p> </sec> <sec id="ss2"> <title>Methods:</title> <p>Truven Health MarketScan data identified patients ≥50 years old with inpatient hospitalizations for hip fracture. Patients had ≥12 months of continuous healthcare insurance prior to and following index hospitalization and no hip fracture diagnoses between 7 days and 1 year prior to admission. Predictors and sub-groups of negative outcomes were identified via multiple logistic regression analyses and classification and regression tree (CART) analyses, respectively.</p> </sec> <sec id="ss3"> <title>Results:</title> <p>Post-fracture 1-year all-cause healthcare costs (USD$31, 430) were higher than costs for the prior year ($18, 091; <italic>p</italic> < 0.0001). Patients with MAW had greater post-fracture healthcare utilization and costs than those without MAW (<italic>p</italic> < 0.05). Greater post-fracture costs were associated with a higher number of prior hospitalizations and emergency room visits, length of index hospitalization, Charlson Comorbidity Index (CCI), and discharge status; diagnosis of rheumatoid arthritis, osteoarthritis, or osteoporosis; and prior use of antidepressants, anticonvulsants, muscle relaxants, benzodiazepines, opioids, and oral corticosteroids (all <italic>p</italic> < 0.009). High-cost patient sub-groups included those with MAW and high CCI scores.</p> </sec> <sec id="ss4"> <title>Conclusions:</title> <p>Negative post-fracture outcomes were associated with MAW vs no MAW, prior hospitalizations, comorbidities, and medications.</p> </sec> </abstract>