Shorter length of hospital stay for hip fracture in those with dementia and without a known diagnosis of osteoporosis in
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RESEARCH ARTICLE
Open Access
Shorter length of hospital stay for hip fracture in those with dementia and without a known diagnosis of osteoporosis in the USA Rafia S. Rasu1,2, Rana Zalmai1, Aliza R. Karpes Matusevich1, Suzanne L. Hunt3, Milind A. Phadnis3 and Nahid Rianon4,5*
Abstract Background: 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. (Continued on next page)
* Correspondence: [email protected] 4 Department of Family and Community Medicine, The University of Texas Health Science Center at Houston, McGovern Medical School, 6341 Fannin Street, #JJL 324C, Houston, TX 77030, USA 5 Division of Geriatric and Palliative Medicine, Department of Internal Medicine, The University of Texas Health Science Center at Houston, McGovern Medical School, TX, Houston, USA Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits 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 lin
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