Fractures Associated with Osteoporosis Jumped 55
Percent from 1995 to 2006
Osteoporosis is primarily
a disease of elderly women: about 90% of those with injuries
July
21, 2009 - The hospitalization rate of patients admitted for
treatment of hip, pelvis and other fractures associated with
osteoporosis increased by 55 percent between 1995 and 2006. And, about
90 percent of these patients were senior citizens and almost all of
these were women, according to the latest News and Numbers from the
Agency for Healthcare Research and Quality.
The hospitalizations that involved an injury likely
due to osteoporosis increased to just over 254,000 hospital stays
totaling $2.4 billion in hospital costs in 2006. About 90 percent of the
cost was paid by Medicare.
An estimated 10 million Americans – primarily older
people - suffer from osteoporosis, which causes bones to become brittle
and weak. Fractures associated with osteoporosis can be slow to heal,
and they also can cause debilitating pain, disability, deformities and
occasionally death.
The federal agency's study also found that
fractures associated with osteoporosis:
● Accounted for one-fourth of the roughly 1
million hospitalizations in 2006 of patients with osteoporosis.
● Cost hospitals $2.4 billion in 2006.
● Caused women to be six times more likely to be
hospitalized than men.
● Involved mostly older patients: 90 percent of
hospitalizations were for age 65 and older and 37 percent for patients
age 85 and older.
● Were highest in the Midwest (107 per 100,000
people) and lowest in the West (68 per 100,000 people).
Other Highlights
● Injuries were noted in one-fourth of all stays
with an osteoporosis diagnosis. Pathological fractures (i.e.,
spontaneous and stress fractures), hip fractures, and fractures of the
vertebrae, ribs, and pelvis were the most frequently occurring injuries
among these patients.
● Nearly 90 percent of stays involving an injury
likely due to osteoporosis occurred among patients 65 years and older;
37 percent occurred among patients 85 and older.
● Females accounted for nearly 89 percent of
injurious osteoporosis stays and had hospitalization rates that were
more than six times higher than males.
● Treatments of hip and leg fractures and
dislocations were performed in 16.4 percent of all injurious
osteoporosis stays, and 8.1 percent of these stays noted a hip
replacement.
“Despite its prevalence
and impact, osteoporosis is both a preventable and treatable condition.
Vitamin D, a diet high in calcium, regular exercise, and access to bone
mineral density screenings and medical treatment can prevent, improve,
and slow the progression of the condition,” according to the authors of
the report.
“However, barriers to
care, such as variations and limitations in provider coverage of
screening tests, could inhibit early detection and treatment, creating a
substantial strain on the U.S. healthcare system as the population ages.
Findings
In 2006, there were
1,043,900 hospitalizations citing an osteoporosis diagnosis, and nearly
one-fourth (254,000 stays) also noted an injury that was likely due to
or exacerbated by osteoporosis (table 1). Because it is difficult to
determine if the osteoporosis diagnosis directly contributed to the
hospitalization or was simply an incidental diagnosis made during a
hospitalization for another condition, this brief focuses on those
hospital stays noting both an osteoporosis diagnosis and an injury.
About Osteoporosis
Osteoporosis makes your
bones weak and more likely to break. Anyone can develop
osteoporosis, but it is common in older women. As many as half
of all women and a quarter of men older than 50 will break a
bone due to osteoporosis.
Risk factors include
● Getting older
● Being small and thin
● Having a family history of osteoporosis
● Taking certain medicines
● Being a white or Asian woman
● Having osteopenia, which is low bone mass
Osteoporosis is a
silent disease. You might not know you have it until you break a
bone. A bone mineral density test is the best way to check your
bone health. To keep bones strong, eat a diet rich in calcium
and vitamin D, exercise and do not smoke. If needed, medicines
can also help.
Table 1 below compares
the utilization of hospital care for stays noting an osteoporosis
diagnosis to the average hospitalization. Hospitalizations involving
injurious osteoporosis had a longer length of stay (5.5 days versus 5.1
days), yet cost approximately $300 less per stay than the average
hospitalization ($9,600 versus $9,900). In 2006, injurious osteoporosis
hospitalizations totaled $2.4 billion in hospital costs.
Patients who had an
osteoporosis diagnosis and an injury were admitted through the emergency
department more often than the average hospitalization (67.3 percent
versus 55.7 percent, respectively).
Patients hospitalized
with osteoporosis and injury were four times as likely to be discharged
to a long-term care facility, such as a nursing home or rehabilitation
center (56.5 percent versus 15.9 percent), and slightly more likely to
be discharged to home health care (14.5 percent versus 11.0 percent)
than the average patient.
Osteoporosis is
primarily a disease striking women
Osteoporosis more
commonly occurs in females; women are four times more likely to be
diagnosed with the disease than men.As shown in table 1, 88.6 percent of
hospitalizations noting an osteoporosis diagnosis and an injury occurred
among female patients, while only 11.4 percent occurred among males.
Overall, the rate of
hospitalization for injurious osteoporosis by gender was 149 stays per
100,000 population for females and 20 stays per 100,000 population for
males—a rate more than six times higherfor women than for men.
Osteoporosis is
primarily a disease of the elderly.
Nearly 90 percent of
stays citing injurious osteoporosis occurred among patients aged 65
years and over. Patients 85 years and older accounted for 37.2 percent
of hospitalizations involving an injury likely due to osteoporosis. The
average age of patients with injurious osteoporosis was 79.5 years—more
than 21 years older than the average hospitalization (58.1 years).
The rate of
hospitalization for injurious osteoporosis increased with age for both
males and females.
For males, patients
under the age of 45 years had a rate of 1 stay per 100,000 population;
this increased to nearly 500 stays per 100,000 population for males ages
85 and older. For females under the age of 45 years, the rate of
hospitalizations involving an injury likely due to osteoporosis was 2
stays per 100,000 population; this increased to almost 2,400 stays per
100,000 for females over the age of 85.
In fact, the report
says, female hospitalization rates for injurious osteoporosis were five
times higher than rates for males among patients 65 years and older.
Medicare is primary
payer
Due to the high
percentage of elderly patients with an osteoporosis diagnosis and an
injury, Medicare was the primary payer for 87.4 percent of all stays
citing injurious osteoporosis, followed by private insurance (8.6
percent) (table 1).
Comparatively, Medicare
is the primary payer in less than half of all hospitalizations, and
private insurance is the payer in slightly less than 30 percent.
Medicaid and the uninsured accounted for only 2.1 and 0.6 percent of all
hospitalizations with injurious osteoporosis, respectively. In
comparison, patients with Medicaid and the uninsured comprised 12.3 and
5.8 percent, respectively, of all hospital stays.
Midwest, Northeast
lead the nation
Overall, the Midwest had
the highest rate of hospitalizations for injurious osteoporosis, with
107 stays per 100,000 population, followed by the Northeast, with 87
stays per 100,000 population.
Rates inthe South
and West were considerably lower. The South had 81 stays per 100,000
population, and the West had the lowest rate, at 68 stays per 100,000
population. The Midwest continued to have the highest rate of
hospitalizations for injurious osteoporosis, even when adjusted for
differences in the age and gender distributions of each region (data not
shown).
In 2006, 24.3 percent of
all stays noting an osteoporosis diagnosis also involved an injury.
Table 2 shows the top 10 most common injuries for stays noting both an
osteoporosis diagnosis and an injury.
Hip fracture was the
most expensive injury ($12,100) and required the longest hospital stay
(5.7 days). In fact, as demonstrated in table 1, injurious osteoporosis
stays averaged $900 more in hospital costs than all stays noting an
osteoporosis diagnosis ($9,600 versus $8,700) and had a longer length of
stay (5.5 days versus 5.2 days).
Procedures related
directly to the diagnosis or treatment of injuries commonly associated
with osteoporosis accounted for many of the ten most common procedures.
For example, the treatment of hip fractures was performed in 16.4
percent of all injurious osteoporosis stays, and 8.1 percent cited a hip
replacement.
Other common procedures
that may be associated with osteoporosis included blood transfusion
(13.3 percent), treatment of a fracture or dislocation of the lower
extremity (other than hip or femur) (3.2 percent), physical therapy (2.7
percent), and treatment of fracture or dislocation of the radius and
ulna (2.3 percent).
Table 1. Characteristics of hospitalizations citing an
osteoporosis diagnosis compared to hospitalizations for all
conditions, 2006
All hospitalizations citing osteoporosis and an injury
All hospitalizations citing an osteoporosis diagnosis
All hospitalizations*
Utilization characteristics
Total number of hospitalizations
254,000
1,043,900
30,142,300
Mean length of stay, days
5.5
5.2
5.1
Mean cost per hospitalization
$9,600
$8,700
$9,900
Aggregate costs
$2.4 billion
$25.9 billion
$297.6 billion
Percentage admitted through the emergency department
67.3%
59.1%
55.7%
Percentage died in hospital
1.7%
2.3%
2.6%
Percentage discharged to home health care
14.5%
16.2%
11.0%
Percentage discharged to a long-term care facility
56.5%
35.2%
15.9%
Patient characteristics
Percentage of female patients
88.6%
89.5%
53.3%
Average age of patients, in years
79.5
76.9
58.1
Percentage of stays by age:
Less than 45 years
1.0%
1.7%
25.5%
45 to 64 years
9.2%
13.6%
30.2%
65 to 84 years
52.6%
55.9%
34.9%
85 years and older
37.2%
28.9%
9.9%
Percentage of stays by payer:
Medicare
87.4%
84.3%
48.7%
Private insurance
8.6%
11.0%
29.5%
Medicaid
2.1%
3.0%
12.3%
Uninsured
0.6%
0.6%
5.8%
* Hospital stays for newborns and maternal childbirth have
been excluded. Source: AHRQ, Center for Delivery,
Organization, and Markets, Healthcare Cost and Utilization
Project, Nationwide Inpatient Sample, 2006.
Table 2. The top 10 injuries commonly associated with
hospitalizations citing an osteoporosis diagnosis, 2006*
All-listed injury
Number of stays
Percentage of all injurious osteoporosis hospitalizations
Mean hospital cost
Mean length of stay (days)
In-hospital death rate
Pathological fracture
(i.e., spontaneous and stress fracture)
74,800
29.4%
$9,700
5.0
0.7%
Hip fracture
60,000
23.6%
$12,100
5.7
1.6%
Fractures of vertebrae, ribs, and pelvis
51,200
20.2%
$7,300
4.8
0.9%
Superficial injury, contusion
25,100
9.9%
$4,800
3.9
0.3%
Leg fracture
22,700
8.9%
$9,800
4.9
0.9%
Arm fracture
22,500
8.9%
$8,100
4.1
0.7%
Other injuries and conditions due to external causes
20,900
8.2%
$5,500
3.8
1.1%
Sprains and strains
6,700
2.6%
$4,900
3.5
0.5%
Intracranial injury
6,400
2.5%
$9,500
5.0
7.3%
Open wounds of extremities
4,800
1.9%
$7,100
5.5
0.0%
Total injurious osteoporosis hospitalizations
254,000
100.0%
$9,600
5.5
1.7%
*Number and percentage of hospital stays based on all-listed
injury diagnoses; all other characteristics are based on
injury as the principal diagnosis. Note that a hospital stay
may involve more than one type of injury.
Source: AHRQ, Center for Delivery, Organization, and
Markets, Healthcare Cost and Utilization Project, Nationwide
Inpatient Sample, 2006.
This AHRQ" News and Numbers" is based on data in
"U.S. Hospitalizations Involving Osteoporosis and Injury, 2006." The
report uses statistics from the 2006 Nationwide Inpatient Sample, a
database of hospital inpatient stays that is nationally representative
of inpatient stays in all short-term, non-Federal hospitals. The data
are drawn from hospitals that comprise 90 percent of all discharges in
the United States and include all patients, regardless of insurance
type, as well as the uninsured. The report also uses statistics from a
special disparities analysis file created from the Healthcare Cost and
Utilization Project 2006 State Inpatient Databases.
Data Source
The estimates in this Statistical Brief are based
upon data from the HCUP Nationwide Inpatient Sample (NIS) for 2006.
Historical data were drawn from the 1995, 1996, 1997, 1998, 1999, 2000,
2001, 2002, 2003, 2004, and 2005 NIS. Supplemental sources included data
from the U.S. Census Bureau, Population Division, Annual Estimates of
the Population for the United States, Regions, and Divisions and U.S.
Census Bureau, Current Population Reports.
About HCUP
HCUP is a family of powerful health care databases,
software tools, and products for advancing research. Sponsored by the
Agency for Healthcare Research and Quality (AHRQ), HCUP includes the
largest all-payer encounter-level collection of longitudinal health care
data (inpatient, ambulatory surgery, and emergency department) in the
United States, beginning in 1988. HCUP is a Federal-State-Industry
Partnership that brings together the data collection efforts of many
organizations—such as State data organizations, hospital associations,
private data organizations, and the Federal government—to create a
national information resource.
Keep up with the latest news for senior citizens, baby
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July
21, 2009 - The hospitalization rate of patients admitted for
treatment of hip, pelvis and other fractures associated with
osteoporosis increased by 55 percent between 1995 and 2006. And, about
90 percent of these patients were senior citizens and almost all of
these were women, according to the latest News and Numbers from the
Agency for Healthcare Research and Quality. 