Economic Burden of Osteoporosis-Related Fractures in Medicaid

Mar 1, 2007, 00:00 AM
Section Title :
Section Order : 4
First Page :


There are limited studies concerning the economic burden of osteoporosis in the Medicaid population. This study estimated the direct cost of osteoporosis-related fractures (OPFx) to state Medicaid budgets.


This retrospective analysis utilized Medicaid claims databases from three states, which included approximately 8 million Medicaid recipients. The study sample had at least one claim for an osteoporosis diagnosis (733.0x) between January 1, 2000 and December 31, 2001. Beneficiaries with a fracture and a diagnosis of osteoporosis were assigned to the case cohort. A propensity score-based matching method was used to select a cohort of controls with osteoporosis but without a fracture. An exponential conditional mean model was used to estimate the incremental annual cost associated with fractures.


The study cohort (n = 7626) and a 1:1 matched control group were identified. The study cohort was 85.8% female, had an average age of 65 years, were 53.2% white, and 48.9% were eligible for Medicare. There were significant increases (all P 0.05) from the preperiod to study period for this cohort in the proportion that had at least one hospital admission (14.0% vs. 26.5%), nursing home admission (9.2% vs. 17.2%), home health (39.1% vs. 49.3%), or emergency room visit (21.3% vs. 31.9%). In contrast, the control cohort had very little increase in utilization. The regression-adjusted incremental cost for osteoporosis-related expenses in the year after fracture was estimated at $4007 per patient. The estimated incremental cost was $5370 for the subset of patients who were eligible for Medicare.


The economic burden of osteoporosis-related fractures on state Medicaid budgets is substantial.
HEOR Topics :
  • Cost/Cost of Illness/Resource Use Studies
  • Economic Evaluation
  • Musculoskeletal Disorders
  • Retrospective Databases: Electronic Medical and Health Records, Admin Claims
  • Specific Diseases & Conditions
  • Study Approaches
Tags :
  • claims analysis
  • fracture
  • Medicaid
  • osteoporosis
Regions :
  • North America