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Health care utilization and expenditures in the United States: a study of osteoporosis-related fractures

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Abstract

Background: More than 1.5 million fractures occur due to osteoporosis each year. This study examines the annual health care utilization and associated expenditures of osteoporotic patients who sustain a new fragility fracture and of those without a new fracture. Methods and procedures: The study sample from commercial claims databases consisted of patients enrolled in US plans between January 1, 1997, and December 31, 2001. Patients with both an osteoporosis diagnosis and a related fracture were classified as “osteoporosis with concurrent fracture”; all other osteoporosis patients were classified as “osteoporosis without concurrent fracture.” Annual utilization and expenditures for the concurrent-fracture cohort were compared with those without concurrent fracture, as well as with a group of patients without osteoporosis (controls) that was matched to the concurrent-fracture cohort based on age, gender, US region, health plan type, and length of enrollment. Exponential conditional mean models were used to compute regression-adjusted total expenditures across the groups. The differences in adjusted expenditures were used to generate the economic burden-of-illness estimates. Results: Osteoporosis patients with concurrent fracture incurred more than twice the overall health care expenditures in the study period, compared with those without fracture (US $15,942 vs $6,476), and nearly three times those of the control group (US $15,942 vs $4,658). Approximately 25% of the overall health care expenditures (US $4,014 of $15,942) for the concurrent-fracture group were osteoporosis-related expenditures, leading to the conclusion that comorbid conditions in osteoporosis patients with concurrent fracture contribute significantly to overall health care costs. Some of these comorbidity-related costs were likely due to pain-related disorders, which occurred significantly more frequently in the concurrent-fracture cohort than in the other groups. Conclusion: Osteoporosis-related expenditures, particularly those related to fracture, were substantial. However, non-osteoporosis-related expenditures to treat comorbid conditions constituted 75% of the overall health care costs in the year after an osteoporosis-related fracture, which warrants further investigation.

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Acknowledgements

Funding: The authors gratefully acknowledge that funding for this analysis was provided by Eli Lilly and Company.

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Authors and Affiliations

  1. Outcomes Research & Econometrics, Medstat, 125 Cambridge Park Drive, Cambridge, MA 02140, USA

    Lucinda Strycker Orsini & Shaohung Wang

  2. Eli Lilly and Company, Indianapolis, Indiana, USA

    Matthew D. Rousculp

  3. Medstat, Hampden, Maine, USA

    Stacey R. Long

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  1. Lucinda Strycker Orsini
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  2. Matthew D. Rousculp
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  3. Stacey R. Long
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  4. Shaohung Wang
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Correspondence to Lucinda Strycker Orsini.

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Orsini, L.S., Rousculp, M.D., Long, S.R. et al. Health care utilization and expenditures in the United States: a study of osteoporosis-related fractures. Osteoporos Int 16, 359–371 (2005). https://doi.org/10.1007/s00198-004-1694-2

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  • DOI: https://doi.org/10.1007/s00198-004-1694-2

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