Economic burden of osteoporosis-related fractures in Medicaid
Economic burden of osteoporosis-related fractures in Medicaid
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DOI：
10.1111/j.1524-4733.2006.00161.x
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发表时间：
2007-03-01
期刊：
影响因子：
4.5
通讯作者：
Meadows, Eric S.
中科院分区：
文献类型：
--
作者：
Rousculp, Matthew D.;Long, Stacey R.;Meadows, Eric S.
目的：关于医疗补助人群骨质疏松症经济负担的研究有限。这项研究估计了骨质疏松相关骨折（OPFx）对国家医疗补助预算的直接成本。方法：本回顾性分析利用了来自三个州的医疗补助索赔数据库，其中包括大约800万医疗补助接受者。研究样本在2000年1月1日至2001年12月31日期间至少有一例骨质疏松症诊断（733.0例）。有骨折和骨质疏松诊断的受益人被分配到病例队列。采用基于倾向评分的匹配方法选择一组骨质疏松但无骨折的对照组。使用指数条件平均模型来估计与裂缝相关的年增量成本。结果：确定了研究队列（n = 7626）和1:1匹配的对照组。研究队列中85.8%为女性，平均年龄为65岁，53.2%为白人，48.9%有资格享受医疗保险。从研究前到研究期间，至少有一次住院（14.0%比26.5%）、疗养院（9.2%比17.2%）、家庭健康（39.1%比49.3%）或急诊室就诊（21.3%比31.9%）的比例显著增加（均P < 0.05）。相比之下，对照组的利用率几乎没有增加。骨折后一年骨质疏松相关费用的回归调整增量成本估计为每位患者4007美元。对于符合医疗保险资格的患者亚组，估计增量成本为5370美元。结论：骨质疏松相关骨折对国家医疗补助预算的经济负担是巨大的。
Objective: There are limited studies concerning the economic burden of osteoporosis in the Medicaid population. This study estimated the direct cost of osteoporosis-related fractures (OPFx) to state Medicaid budgets.Methods: This retrospective analysis utilized Medicaid claims databases from three states, which included approximately 8 million Medicaid recipients. The study sample had at least one claim for an osteoporosis diagnosis (733.0x) between January 1, 2000 and December 31, 2001. Beneficiaries with a fracture and a diagnosis of osteoporosis were assigned to the case cohort. A propensity score-based matching method was used to select a cohort of controls with osteoporosis but without a fracture. An exponential conditional mean model was used to estimate the incremental annual cost associated with fractures.Results: The study cohort (n = 7626) and a 1:1 matched control group were identified. The study cohort was 85.8% female, had an average age of 65 years, were 53.2% white, and 48.9% were eligible for Medicare. There were significant increases (all P < 0.05) from the preperiod to study period for this cohort in the proportion that had at least one hospital admission (14.0% vs. 26.5%), nursing home admission (9.2% vs. 17.2%), home health (39.1% vs. 49.3%), or emergency room visit (21.3% vs. 31.9%). In contrast, the control cohort had very little increase in utilization. The regression-adjusted incremental cost for osteoporosis-related expenses in the year after fracture was estimated at $4007 per patient. The estimated incremental cost was $5370 for the subset of patients who were eligible for Medicare.Conclusions: The economic burden of osteoporosis-related fractures on state Medicaid budgets is substantial.