{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T17:59:06Z","timestamp":1758477546679},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2012,10,16]],"date-time":"2012-10-16T00:00:00Z","timestamp":1350345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>This study evaluated reasons for healthcare expenditures both before and after the occurrence of fractures among Medicare beneficiaries. In a previous study we examined healthcare expenditures in the 6 months before and after fractures. The difference\u2014\u201cincremental\u201d expenditures\u2014provides one estimate of the potentially avoidable costs associated with fractures. We constructed a second estimate of the cost burden\u2014\u201cattributable\u201d expenditures\u2014using only those costs recorded in claims with fracture diagnosis codes. Attributable expenditures accounted for only 24% to 60% of incremental expenditures, depending on the fracture site. We examined health care expenditures between 1999 and 2005 among Medicare beneficiaries who experienced fractures (cases) and among beneficiaries who did not experience fractures (controls), matched to cases on age, race, and sex. We also examined healthcare expenditures for cases and controls for 24 months prior to the fracture index date. When expenditures associated with diagnoses for aftercare, joint pain, and osteoporosis, other musculoskeletal diagnoses, pneumonia, and pressure ulcers were included, the proportion of incremental costs directly attributable to fracture care rose to 72% to 88%. Expenditures prior to fracture were higher for cases than controls, and the rate of increase accelerated over the 12 months prior to the hip fracture. Our findings confirm that the original incremental cost analysis constituted a satisfactory method for estimating avoidable costs associated with fractures. We also conclude that those with fractures had much higher and growing healthcare expenditures in the 12 months prior to the event, compared with age-, race-, and sex-matched controls. This suggests that patterns of healthcare services utilization may provide a means to improve fracture prediction rules. \u00a9 2013 American Society for Bone and Mineral Research.<\/jats:p>","DOI":"10.1002\/jbmr.1789","type":"journal-article","created":{"date-parts":[[2012,10,16]],"date-time":"2012-10-16T12:56:48Z","timestamp":1350392208000},"page":"816-820","source":"Crossref","is-referenced-by-count":14,"title":["A close examination of healthcare expenditures related to fractures"],"prefix":"10.1093","volume":"28","author":[{"given":"Meredith L","family":"Kilgore","sequence":"first","affiliation":[{"name":"Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey R","family":"Curtis","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Delzell","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J","family":"Becker","sequence":"additional","affiliation":[{"name":"Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarun","family":"Arora","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth G","family":"Saag","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A","family":"Morrisey","sequence":"additional","affiliation":[{"name":"Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2012,10,16]]},"reference":[{"issue":"12","key":"2024020318414392500_bib1","doi-asserted-by":"crossref","first-page":"2050","DOI":"10.1359\/jbmr.090523","article-title":"Health care expenditures associated with skeletal fractures among Medicare beneficiaries, 1999\u20132005","volume":"24","author":"Kilgore","year":"2009","journal-title":"J Bone Miner Res."},{"issue":"3","key":"2024020318414392500_bib2","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1007\/s11926-010-0097-y","article-title":"The societal burden of osteoporosis","volume":"12","author":"Becker","year":"2010","journal-title":"Curr Rheumatol Rep."},{"issue":"9","key":"2024020318414392500_bib3","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1093\/gerona\/glq093","article-title":"Health services utilization after fractures: evidence from Medicare","volume":"65","author":"Becker","year":"2010","journal-title":"J Gerontol A Biol Sci Med Sci."},{"issue":"21","key":"2024020318414392500_bib4","doi-asserted-by":"crossref","first-page":"1940","DOI":"10.1001\/archinternmed.2010.410","article-title":"Predicting hip and major osteoporotic fractures using administrative data","volume":"170","author":"Yun","year":"2010","journal-title":"Arch Intern Med."},{"key":"2024020318414392500_bib5","author":"Centers for Medicare & Medicaid Services (CMS)"},{"key":"2024020318414392500_bib6","author":"Agency for Healthcare Research and Quality, Health Care Cost and Utilization Project (HCUP)"},{"issue":"7","key":"2024020318414392500_bib7","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1016\/j.annepidem.2006.12.004","article-title":"Risk-adjusted mortality rates of elderly veterans with hip fractures","volume":"17","author":"Bass","year":"2007","journal-title":"Ann Epidemiol."},{"issue":"1","key":"2024020318414392500_bib8","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.outlook.2006.06.006","article-title":"Cost of care for seniors hospitalized for hip fracture and related procedures","volume":"55","author":"Titler","year":"2007","journal-title":"Nurs Outlook."},{"issue":"11","key":"2024020318414392500_bib9","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1016\/j.injury.2005.05.024","article-title":"The acute medical care costs of fall-related injuries among the U.S. older adults","volume":"36","author":"Roudsari","year":"2005","journal-title":"Injury."},{"issue":"2","key":"2024020318414392500_bib10","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1007\/s00198-005-1993-2","article-title":"Fragility fracture-related direct medical costs in the first year following a nonvertebral fracture in a managed care setting","volume":"17","author":"Ohsfeldt","year":"2006","journal-title":"Osteoporos Int."},{"issue":"4","key":"2024020318414392500_bib11","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s00198-004-1694-2","article-title":"Health care utilization and expenditures in the United States: a study of osteoporosis-related fractures","volume":"16","author":"Orsini","year":"2005","journal-title":"Osteoporos Int."},{"issue":"2","key":"2024020318414392500_bib12","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1111\/j.1524-4733.2006.00161.x","article-title":"Economic burden of osteoporosis-related fractures in Medicaid","volume":"10","author":"Rousculp","year":"2007","journal-title":"Value Health."},{"issue":"4","key":"2024020318414392500_bib13","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s001980200033","article-title":"Melton LJ 3rd. Direct medical costs attributable to osteoporotic fractures","volume":"13","author":"Gabriel","year":"2002","journal-title":"Osteoporos Int."},{"issue":"1","key":"2024020318414392500_bib14","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1007\/s001980050196","article-title":"Incremental cost of medical care after hip fracture and first vertebral fracture: the Rotterdam study","volume":"10","author":"De Laet","year":"1999","journal-title":"Osteoporos Int."},{"issue":"20","key":"2024020318414392500_bib15","doi-asserted-by":"crossref","first-page":"2381","DOI":"10.1001\/jama.298.20.2381","article-title":"Study of Osteoporotic Fractures (SOF) and Osteoporotic Fractures in Men Study (MrOS) Research Groups. High-trauma fractures and low bone mineral density in older women and men","volume":"298","author":"Mackey","year":"2007","journal-title":"JAMA."}],"container-title":["Journal of Bone and Mineral Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjbmr.1789","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/28\/4\/816\/56564286\/1789_ftp.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/28\/4\/816\/56564286\/1789_ftp.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T14:48:02Z","timestamp":1710341282000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbmr\/article\/28\/4\/816-820\/7598765"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,10,16]]},"references-count":15,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2012,10,16]]},"published-print":{"date-parts":[[2013,4,1]]}},"URL":"https:\/\/doi.org\/10.1002\/jbmr.1789","relation":{},"ISSN":["0884-0431","1523-4681"],"issn-type":[{"value":"0884-0431","type":"print"},{"value":"1523-4681","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2013,4,1]]},"published":{"date-parts":[[2012,10,16]]}}}