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Health care utilization and excess costs after pelvic fractures among older people in Germany

SUMMARY: Our study demonstrates a strong increase in utilization of inpatient health care and clear excess costs in older people in the first year after pelvic fracture, the latter even after adjustment for several confounders. Excess costs were particularly high in the first few months and mainly a...

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Autores principales: Andrich, S., Haastert, B., Neuhaus, E., Frommholz, K., Arend, W., Ohmann, C., Grebe, J., Vogt, A., Brunoni, C., Jungbluth, P., Thelen, S., Dintsios, C.-M., Windolf, J., Icks, A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer London 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8510957/
https://www.ncbi.nlm.nih.gov/pubmed/33839895
http://dx.doi.org/10.1007/s00198-021-05935-1
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author Andrich, S.
Haastert, B.
Neuhaus, E.
Frommholz, K.
Arend, W.
Ohmann, C.
Grebe, J.
Vogt, A.
Brunoni, C.
Jungbluth, P.
Thelen, S.
Dintsios, C.-M.
Windolf, J.
Icks, A.
author_facet Andrich, S.
Haastert, B.
Neuhaus, E.
Frommholz, K.
Arend, W.
Ohmann, C.
Grebe, J.
Vogt, A.
Brunoni, C.
Jungbluth, P.
Thelen, S.
Dintsios, C.-M.
Windolf, J.
Icks, A.
author_sort Andrich, S.
collection PubMed
description SUMMARY: Our study demonstrates a strong increase in utilization of inpatient health care and clear excess costs in older people in the first year after pelvic fracture, the latter even after adjustment for several confounders. Excess costs were particularly high in the first few months and mainly attributable to inpatient treatment. INTRODUCTION: We aimed to estimate health care utilization and excess costs in patients aged minimum 60 years up to 1 year after pelvic fracture compared to a population without pelvic fracture. METHODS: In this retrospective population-based observational study, we used routine data from a large statutory health insurance (SHI) in Germany. Patients with a first pelvic fracture between 2008 and 2010 (n=5685, 82% female, mean age 80±9 years) were frequency matched with controls (n=193,159) by sex, age at index date, and index month. We estimated health care utilization and mean total direct costs (SHI perspective) with 95% confidence intervals (CIs) using BCA bootstrap procedures for 52 weeks before and after the index date. We calculated cost ratios (CRs) in 4-week intervals after the index date by fitting mixed two-part models including adjustment for possible confounders and repeated measurement. All analyses were further stratified for men/women, in-/outpatient-treated, and major/minor pelvic fractures. RESULTS: Health care utilization and mean costs in the year after the index date were higher for cases than for controls, with inpatient treatment being particularly pronounced. CRs (95% CIs) decreased from 10.7 (10.2–11.1) within the first 4 weeks to 1.3 (1.2–1.4) within week 49–52. Excess costs were higher for inpatient than for outpatient-treated persons (CRs of 13.4 (12.9–13.9) and 2.3 (2.0–2.6) in week 1–4). In the first few months, high excess costs were detected for both persons with major and minor pelvic fracture. CONCLUSION: Pelvic fractures come along with high excess costs and should be considered when planning and allocating health care resources.
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spelling pubmed-85109572021-10-27 Health care utilization and excess costs after pelvic fractures among older people in Germany Andrich, S. Haastert, B. Neuhaus, E. Frommholz, K. Arend, W. Ohmann, C. Grebe, J. Vogt, A. Brunoni, C. Jungbluth, P. Thelen, S. Dintsios, C.-M. Windolf, J. Icks, A. Osteoporos Int Original Article SUMMARY: Our study demonstrates a strong increase in utilization of inpatient health care and clear excess costs in older people in the first year after pelvic fracture, the latter even after adjustment for several confounders. Excess costs were particularly high in the first few months and mainly attributable to inpatient treatment. INTRODUCTION: We aimed to estimate health care utilization and excess costs in patients aged minimum 60 years up to 1 year after pelvic fracture compared to a population without pelvic fracture. METHODS: In this retrospective population-based observational study, we used routine data from a large statutory health insurance (SHI) in Germany. Patients with a first pelvic fracture between 2008 and 2010 (n=5685, 82% female, mean age 80±9 years) were frequency matched with controls (n=193,159) by sex, age at index date, and index month. We estimated health care utilization and mean total direct costs (SHI perspective) with 95% confidence intervals (CIs) using BCA bootstrap procedures for 52 weeks before and after the index date. We calculated cost ratios (CRs) in 4-week intervals after the index date by fitting mixed two-part models including adjustment for possible confounders and repeated measurement. All analyses were further stratified for men/women, in-/outpatient-treated, and major/minor pelvic fractures. RESULTS: Health care utilization and mean costs in the year after the index date were higher for cases than for controls, with inpatient treatment being particularly pronounced. CRs (95% CIs) decreased from 10.7 (10.2–11.1) within the first 4 weeks to 1.3 (1.2–1.4) within week 49–52. Excess costs were higher for inpatient than for outpatient-treated persons (CRs of 13.4 (12.9–13.9) and 2.3 (2.0–2.6) in week 1–4). In the first few months, high excess costs were detected for both persons with major and minor pelvic fracture. CONCLUSION: Pelvic fractures come along with high excess costs and should be considered when planning and allocating health care resources. Springer London 2021-04-10 2021 /pmc/articles/PMC8510957/ /pubmed/33839895 http://dx.doi.org/10.1007/s00198-021-05935-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Article
Andrich, S.
Haastert, B.
Neuhaus, E.
Frommholz, K.
Arend, W.
Ohmann, C.
Grebe, J.
Vogt, A.
Brunoni, C.
Jungbluth, P.
Thelen, S.
Dintsios, C.-M.
Windolf, J.
Icks, A.
Health care utilization and excess costs after pelvic fractures among older people in Germany
title Health care utilization and excess costs after pelvic fractures among older people in Germany
title_full Health care utilization and excess costs after pelvic fractures among older people in Germany
title_fullStr Health care utilization and excess costs after pelvic fractures among older people in Germany
title_full_unstemmed Health care utilization and excess costs after pelvic fractures among older people in Germany
title_short Health care utilization and excess costs after pelvic fractures among older people in Germany
title_sort health care utilization and excess costs after pelvic fractures among older people in germany
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8510957/
https://www.ncbi.nlm.nih.gov/pubmed/33839895
http://dx.doi.org/10.1007/s00198-021-05935-1
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