Shorter length of hospital stay for hip fracture in those with dementia and without a known diagnosis of osteoporosis in the USA

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dc.creatorRasu, Rafia S.
dc.creatorZalmai, Rana
dc.creatorKarpes Matusevich, Aliza R.
dc.creatorHunt, Suzanne L.
dc.creatorPhadnis, Milind A.
dc.creatorRianon, Nahid
dc.creator.orcid0000-0002-6485-9629 (Rasu, Rafia S.)
dc.date.accessioned2022-11-21T19:47:05Z
dc.date.available2022-11-21T19:47:05Z
dc.date.issued2020-12-03
dc.description.abstractBACKGROUND: About 50% of all hospitalized fragility fracture cases in older Americans are hip fractures. Approximately 3/4 of fracture-related costs in the USA are attributable to hip fractures, and these are mostly covered by Medicare. Hip fracture patients with dementia, including Alzheimer's disease, have worse health outcomes including longer hospital length of stay (LOS) and charges. LOS and hospital charges for dementia patients are usually higher than for those without dementia. Research describing LOS and acute care charges for hip fractures has mostly focused on these outcomes in trauma patients without a known pre-admission diagnosis of osteoporosis (OP). Lack of documented diagnosis put patients at risk of not having an appropriate treatment plan for OP. Whether having a diagnosis of OP would have an effect on hospital outcomes in dementia patients has not been explored. We aim to investigate whether having a diagnosis of OP, dementia, or both has an effect on LOS and hospital charges. In addition, we also report prevalence of common comorbidities in the study population and their effects on hospital outcomes. METHODS: We conducted a cross-sectional analysis of claims data (2012-2013) for 2175 Medicare beneficiaries (>/=65 years) in the USA. RESULTS: Compared to those without OP or dementia, patients with demenia only had a shorter LOS (by 5%; P = .04). Median LOS was 6 days (interquartile range [IQR]: 5-7), and the median hospital charges were $45,100 (IQR: 31,500 - 65,600). In general, White patients had a shorter LOS (by 7%), and those with CHF and ischemic heart disease (IHD) had longer LOS (by 7 and 4%, respectively). Hospital charges were 6% lower for women, and 16% lower for White patients. CONCLUSION: This is the first study evaluating LOS in dementia in the context of hip fracture which also disagrees with previous reporting about longer LOS in dementia patients. Patients with CHF and IHD remains at high risk for longer LOS regardless of their diagnosis of dementia or OP.
dc.description.sponsorshipNot Applicable.
dc.identifier.citationRasu, R. S., Zalmai, R., Karpes Matusevich, A. R., Hunt, S. L., Phadnis, M. A., & Rianon, N. (2020). Shorter length of hospital stay for hip fracture in those with dementia and without a known diagnosis of osteoporosis in the USA. BMC geriatrics, 20(1), 523. https://doi.org/10.1186/s12877-020-01924-x
dc.identifier.issn1471-2318
dc.identifier.issue1
dc.identifier.urihttps://hdl.handle.net/20.500.12503/31952
dc.identifier.volume20
dc.publisherBioMed Central Ltd.
dc.relation.urihttps://doi.org/10.1186/s12877-020-01924-x
dc.rights.holder© The Author(s). 2020
dc.rights.licenseAttribution 4.0 International (CC BY 4.0)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceBMC Geriatrics
dc.subjectcosts
dc.subjectdementia
dc.subjecthip fracture
dc.subjectlength of stay
dc.subjectMedicare
dc.subjectolder adults
dc.subjectosteoporosis
dc.subject.meshAged
dc.subject.meshAged, 80 and over
dc.subject.meshCross-Sectional Studies
dc.subject.meshFemale
dc.subject.meshHip Fractures / diagnosis
dc.subject.meshHip Fractures / epidemiology
dc.subject.meshHip Fractures / therapy
dc.subject.meshHumans
dc.subject.meshLength of Stay
dc.subject.meshMale
dc.subject.meshMedicare
dc.subject.meshOsteoporosis / diagnosis
dc.subject.meshOsteoporosis /epidemiology
dc.subject.meshOsteoporosis / therapy
dc.subject.meshUnited States / epidemiology
dc.titleShorter length of hospital stay for hip fracture in those with dementia and without a known diagnosis of osteoporosis in the USA
dc.typeArticle
dc.type.materialtext

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