Medical care costs associated with vertebral fractures among Medicare beneficiaries 1997 to 2001
Schmier, J., Halpern, M., Kurtz, S., Lau, E., & Edidin, A. (2005). Medical care costs associated with vertebral fractures among Medicare beneficiaries 1997 to 2001. In , pp. S156–S157. .
BACKGROUND CONTEXT: Vertebral compression fractures (VCF)
resulting from osteoporosis are an increasing problem, especially among
the elderly. The medical care costs for patients with VCF are often borne
by Medicare but the costs have not been quantified.
PURPOSE: To analyze resource use and costs associated with vertebral
compression fractures for Medicare beneficiaries from 1997 to 2001.
STUDY DESIGN/SETTING: Retrospective data analysis of the Medicare
5% beneficiary encrypted files.
PATIENT SAMPLE: All individuals with a VCF diagnosis code in the
Medicare Part B, Outpatient Facility, or Inpatient Facility 1997 through
2001 BEF data were identified. Controls were identified and matched for
age group, gender, and state of residence with a 1:10 ratio.
OUTCOME MEASURES: Outcomes were the differences in costs between
VCF patients and controls in the year following an initial VCF
compared with the year previous to the VCF diagnosis. Subgroup analysis
explored outcomes by demographic and geographic characteristics.
METHODS: Costs were calculated based on claims submitted and reimbursements
as recorded in the database. Costs are expressed as 2004$.
RESULTS: We identified 51,700 new VCF cases and selected 505,395
controls who did not have VCF during this period. For VCF patients, mean
reimbursements in the year following a VCF were almost twice as high
as the year before ($17,750 vs. $9,275); reimbursements were 125% higher
for VCF patients compared with matched controls ($17,750 vs. $7,723).
Reimbursements for skilled nursing facilities increased immediately after
a VCF and remained high for one year. The increase in reimbursements
following VCF was higher for men than for women.
CONCLUSIONS: VCF represents a significant cost burden to elderly
patients and to the Medicare system. The extensive costs after initial diagnosis
and the differential patterns of costs by gender warrant further attention.