title: Utilization of Post-Acute Care Following Distal Radius Fracture Among Medicare Beneficiaries.
abstract: OBJECTIVE
  To examine the utilization and cost of post-acute care following isolated distal radius fractures (DRFs) among Medicare beneficiaries.
  
  
  METHODS
  We examined utilization of post-acute care among Medicare beneficiaries who experienced an isolated DRF (n = 38,479) during 2007 using 100% Medicare claims data. We analyzed the effect of patient factors on hospital admission following DRF and the receipt of post-acute care delivered by skilled nursing facilities, inpatient rehabilitation facilities, home health care agencies, and outpatient occupational therapy/physical therapy for the recovery of DRF.
  
  
  RESULTS
  In this cohort of isolated DRF patients, 1,694 (4.4%) were admitted to hospitals following DRF, and 20% received post-acute care. Women and patients with more comorbid conditions were more likely to require hospital admission. The utilization of post-acute care was higher among women, patients who resided in urban areas, and patients of higher socioeconomic status. The average cost per patient of post-acute care services from inpatient rehabilitation facilities and skilled nursing facilities ($15,888/patient) was significantly higher than the average cost other aspects of DRF care and accounted for 69% of the total DRF-related expenditure among patients who received inpatient rehabilitation.
  
  
  CONCLUSIONS
  Sociodemographic factors, including sex, socioeconomic status, and age, were significantly correlated with the use of post-acute care following isolated DRFs, and post-acute care accounted for a substantial proportion of the total expenditures related to these common injuries among the elderly. Identifying patients who will derive the greatest benefit from post-acute care can inform strategies to improve the cost efficiency of rehabilitation and optimize scarce health care resources.
  
  
  METHODS
  Therapeutic III.
authors.affiliation: Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhong
authors.affiliation: Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI.
authors.forename: Elham
authors.initials: E
authors.lastname: Mahmoudi
authors.affiliation: Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI.
authors.forename: Aviram M
authors.initials: AM
authors.lastname: Giladi
authors.affiliation: Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI.
authors.forename: Melissa
authors.initials: M
authors.lastname: Shauver
authors.affiliation: Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Chung
authors.affiliation: Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI. Electronic address: filip@med.umich.edu.
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Waljee
mesh_terms: D000368:Aged; D005260:Female; D018574:Home Care Agencies / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D006278:Medicare; D009788:Occupational Therapy / Q000706:statistics & numerical data; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data; D011885:Radius Fractures / Q000628:therapy*; D012047:Rehabilitation Centers / Q000706:statistics & numerical data; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data; D014481:United States; D014600:Utilization Review
keywords: DRF; Medicare; admission; cost; post–acute care