Hip fracture trends in the United States, 2002 to 2015
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An analysis of United States (US) Medicare claims data from 2002 to 2015 for women aged ≥ 65 years found that age-adjusted hip fracture rates for 2013, 2014, and 2015 were higher than projected, resulting in an estimated increase of more than 11,000 hip fractures.
Hip fractures are a major public health concern due to high morbidity, mortality, and healthcare expenses. Previous studies have reported a decrease in the annual incidence of hip fractures in the US beginning in 1995, coincident with the introduction of modern diagnostic tools and therapeutic agents for osteoporosis. In recent years, there has been less bone density testing and fewer prescriptions for osteoporosis treatments. The large osteoporosis treatment gap raises concern of possible adverse effects on hip fracture rates.
We assessed hip fracture incidence in the US to determine if the previous decline in hip fracture incidence continued. Using 2002 to 2015 Medicare Part A and Part B claims for women ≥ 65 years old, we calculated age-adjusted hip fracture rates, weighting to the 2014 population.
We found that hip fracture rates declined each year from 2002 to 2012 and then plateaued at levels higher than projected for years 2013, 2014, and 2015.
The plateau in age-adjusted hip fracture incidence rate resulted in more than 11,000 additional estimated hip fractures over the time periods 2013, 2014, and 2015. We recommend further study to assess all factors contributing to this remarkable change in hip fracture rate and to develop strategies to reduce the osteoporosis treatment gap.
KeywordsDXA Fracture Medicare Osteoporosis Reimbursement
Chris Hogan of Direct Research, LLC, participated in the development of this manuscript by extracting, collecting, and categorizing data from primary CMS dataset sources.
Acquisition and analysis of data for this study was provided by the National Bone Health Alliance and the International Society for Clinical Densitometry.
Compliance with ethical standards
Conflicts of interest
Dr. Lewiecki has received institutional grant/research support from Amgen, Merck, and Lilly; he has served on scientific advisory boards for Amgen, Merck, Lilly, and Radius. Dr. Steven is a paid data analyst for the International Society for Clinical Densitometry. Dr. Siris is a consultant for Amgen and Radius. Dr. Wright has received institutional grant/research support from Amgen and is a consultant for Pfizer. Dr. Saag has received research grants from Amgen, Lilly, and Merck and has served on scientific advisory boards for Amgen, Merck, and Radius. Dr. Adler has nothing to disclose. Dr. Singer has served on scientific advisory boards for Amgen, Lilly, and Radius; is a consultant for Amgen, Lilly, Merck, Radius, Medtronic, and Hologic; and is on the speakers’ bureau for Amgen and Lilly. Dr. Gagel has nothing to disclose.
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