Clinical and economic characteristics of hip fracture patients with and without muscle atrophy/weakness in the United States

Abstract

This retrospective analysis of hip fracture patients with and without muscle atrophy/weakness (MAW) revealed that those with MAW had significantly higher healthcare utilization and costs compared with hip fracture patients without MAW. Examine the demographics, clinical characteristics, and healthcare resource utilization and costs of hip fracture patients with and without MAW. Using a large US claims database, individuals who were newly hospitalized for hip fracture between 1 Jan 2006 and 30 September 2009 were identified. Patients aged 50-64 years with commercial insurance (Commercial) or 65+ years with Medicare supplemental insurance (Medicare) were included. The first hospitalization for hip fracture was defined as the index stay. Patients were categorized into three cohorts: patients with medical claims associated with MAW over the 12 months before the index stay (pre-MAW), patients whose first MAW claim occurred during or over the 12 months after the index stay (post-MAW), and patients without any MAW claim (no-MAW). Multivariate regressions were performed to assess the association between MAW and healthcare costs over the 12-month post-index period, as well as the probability of re-hospitalization. There were 26,122 Medicare (pre-MAW, 839; post-MAW, 2,761; no-MAW, 22,522) and 5,100 Commercial (pre-MAW, 132; post-MAW, 394; no-MAW, 4,574) hip fracture patients included in this study. Controlling for cross-cohort differences, both the pre-MAW and post-MAW cohorts had significantly higher total healthcare costs (Medicare, $7,308 and $18,753 higher; Commercial, $18,679 and $25,495 higher) than the no-MAW cohort (all p < 0.05) over the 12-month post-index period. The post-MAW cohort in both populations was also more likely to have any all-cause or fracture-related re-hospitalization during the 12-month post-index period. Among US patients with hip fractures, those with MAW had higher healthcare utilization and costs than patients without MAW.