title: Trends and Disparities in Osteoporosis Screening Among Women in the United States, 2008-2014.
abstract: BACKGROUND
  The United States Preventive Services Task Force recommends universal osteoporosis screening among women ages 65+ and targeted screening of younger women, but historically, adherence to these evidence-based recommendations has been suboptimal.
  
  
  METHODS
  To describe contemporary patterns of osteoporosis screening, we conducted a retrospective analysis using the OptumLabs™Data Warehouse, a database of de-identified administrative claims, which includes medical and eligibility information for over 100 million Medicare Advantage and commercial enrollees. Study participants included 1,638,454 women ages 50+ with no prior history of osteoporosis diagnosis, osteoporosis drug use, or hip fracture. Osteoporosis screening during the most recent 2-year period of continuous enrollment was assessed via medical claims. Patient sociodemographics, comorbidities, and utilization of other services were also determined using health insurance files.
  
  
  RESULTS
  Overall screening rates were low: 21.1%, 26.5%, and 12.8% among women ages 50-64, 65-79, and 80+ years, respectively. Secular trends differed significantly by age (P <.001). Between 2008 and 2014, utilization among women ages 50-64 years declined 31.4%, changed little among women 65-79, and increased 37.7% among women 80+ years. Even after accounting for socioeconomic status, health status, and health care utilization patterns, non-Hispanic black women were least likely to be screened, whereas non-Hispanic Asian and Hispanic women were most likely to undergo screening. Marked socioeconomic gradients in screening probabilities narrowed substantially over time, decreasing by 44.5%, 71.9%, and 59.7% among women ages 50-64, 65-79 and 80+ years, respectively.
  
  
  CONCLUSIONS
  Despite significant changes in utilization of osteoporosis screening among women ages 50-64 and 80+, in line with national recommendations, tremendous deficiencies among women 65+ remain.
authors.affiliation: AARP Public Policy Institute, Washington, DC; OptumLabs, Cambridge, Mass. Electronic address: cgillespie@aarp.org.
authors.forename: Catherine W
authors.initials: CW
authors.lastname: Gillespie
authors.affiliation: OptumLabs, Cambridge, Mass.
authors.forename: Pamela E
authors.initials: PE
authors.lastname: Morin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis*; D044469:Racial Groups / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014481:United States
keywords: Disparities; Osteoporosis; Prevention; Screening