Economic burden of osteoporosis-related fractures in Medicaid.
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.
Rousculp
Matthew D
MD
Lilly Research Laboratories, Indianapolis, IN, USA. rousculpmd@lilly.com
Long
Stacey R
SR
Wang
Shaohung
S
Schoenfeld
Michael J
MJ
Meadows
Eric S
ES
D000368:Aged; D000369:Aged, 80 and over; D014487:Centers for Medicare and Medicaid Services, U.S.; D017281:Cost of Illness; D019992:Databases as Topic; D003710:Demography; D004180:Direct Service Costs; D005260:Female; D050723:Fractures, Bone / Q000191:economics* / Q000453:epidemiology / Q000209:etiology; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000191:economics* / Q000453:epidemiology; D012189:Retrospective Studies; D013221:State Health Plans / Q000191:economics* / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology