Kandice A. Kapinos, Ph.D. Economist Professor RAND Corporation Pardee RAND Graduate School 

Most Health Care Costs Associated With Osteoporotic Fractures Occur in First Year

MedicalResearch.com Interview with:

Kandice A. Kapinos, Ph.D. Economist Professor RAND Corporation Pardee RAND Graduate School 

Dr. Kapinos

Kandice A. Kapinos, Ph.D.
RAND Corporation
Pardee RAND Graduate School 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: The economic burden of osteoporotic fractures is substantial with studies estimating the annual healthcare cost burden between $10 to 17 billion. Although estimates from individual studies vary, most studies assessing costs after a fracture only explore up to twelve months following a fracture. There is little investigation of how fracture patients’ costs evolve over a longer post-fracture period.

As osteoporotic fractures are one of the most common causes of disability among older adults and can translate into greater medical costs, we focused on studying Medicare beneficiaries. In fact, previous research has suggested that most of the increase in Medicare spending over time can be explained from costs associated with treating higher risk Medicare beneficiaries.

Our objective in this study was to compare health care costs over a 3-year period of those who experienced a fracture to those who did not among a sample of Medicare beneficiaries who were at an increased risk of having a fracture.

Consistent with previous studies, we found a significant increase in expenditures in the year immediately following a fracture relative to controls: almost $14,000 higher for fractures relative to controls. However, at 2 and 3-years post-fracture, there were no significant differences in the change in expenditures between fracture cases and controls. We note that these findings may be different for beneficiaries living in skilled nursing facilities or other non-community-based settings.

MedicalResearch.com: What should readers take away from your report?

Response: Most of the large healthcare costs associated with osteoporotic fractures are incurred within the first year of a fracture and do not persist beyond that among older adults residing in community-based settings. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Despite there not being longer-term increases in direct healthcare costs for those with fractures, we found in related research that fractures are associated with limitations of functional health, including limitations to activities of daily living, mobility, and gross and fine motor skills up to 4 years after a fracture, though the effects do diminish over time.[1] Thus, these limitations may impose other longer-term financial costs that are not quantified in our current study. Future research could examine some of these other costs that are not direct healthcare costs. 

Disclosures: Kandice Kapinos, Shira Fischer, Andrew Mulcahy, and Orla Hayden are employees of the RAND Corporation, which received an unrestricted grant from Amgen for this research. Rich Barron is an employee of and own stock options in Amgen. This project was supported by Amgen under a contract that provided for independent analysis by the authors. By contract, the authors had the authority to independently revise and submit the manuscript.


Medical Costs for Osteoporosis-Related Fractures Among High-Risk Medicare Beneficiaries
Authors: Kandice A. Kapinos1, PhD; Shira H Fischer2, MD, PhD; Andrew Mulcahy3, MPP, PhD; Orla Hayden4, BS; and Richard Barron5, MS
Journal of the American Geriatrics Society 5th October 2018 

  1. RAND Corporation, 1200 South Hayes Street, Arlington, VA 22202. Twitter: @kandicekapinos
  2. RAND Corporation, 20 Park Plaza, Suite 920, Boston, MA 02116. Twitter: @shirafischer
  3. RAND Corporation, 1200 South Hayes Street, Arlington, VA 22202. Twitter: none
  4. RAND Corporation, 1776 Main St, Santa Monica, CA 90401. Twitter: none
  5. Amgen Inc., Thousand Oaks, CA. Twitter: none

PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/30289961
DOI: http://dx.doi.org/10.1111/jgs.15585

[1] Fischer, S., Kapinos, K. A., Mulcahy, A., Pinto, L., Hayden, O., & Barron, R. (2017). Estimating the long-term functional burden of osteoporosis-related fractures. Osteoporosis International28(10), 2843-2851.

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Oct 14, 2018 @ 12:01 pm 

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