PDF(Pubmed)
Abstract：
UNASSIGNED: Fall injuries are prevalent in older adults, yet whether higher spending occurs after nonfracture (NFFI) and fracture is unknown. We examined whether incident fall injuries, including NFFI and fractures, were associated with higher Medicare spending in 12 months after incident events in older adults.
UNASSIGNED: The Health, Aging, and Body Composition Study included 1 595 community-dwelling adults (53% women, 37% Black; 76.7 ± 2.9 years) with linked Medicare Fee-For-Service (FFS) claims at 2000/01 exam. Incident outpatient and inpatient fall injuries (N = 448) from 2000/01 exam to December 31, 2008 were identified using the first claim with a nonfracture injury diagnosis code with a fall E-code, or a fracture diagnosis code with/without an E-code. Up to 3 participants without fall injuries (N = 1 147) were matched on nonfall events to 448 participants in the fall injury month. We calculated the change in monthly FFS spending in 12 months before versus after index events in both groups. Generalized linear regression with centered outcomes and gamma distributions examined the association of prepost expenditure changes with fall injuries (including NFFI and fractures) adjusting for related covariates.
UNASSIGNED: Monthly spending increased after versus before fall injuries (USD$2 261 vs $981), nonfracture (N = 105; USD$2 083 vs $1 277), and fracture (N = 343; USD$2 315 vs $890) injuries (all p < .0001). However, after adjusting for covariates in final models, fall injuries were not significantly associated with larger increases in spending/month versus nonfall events (differential increase: USD$399.58 [95% CI: -USD$44.95 to $844.11]). Fracture prepost change in monthly spending was similar versus NFFI (differential increase: USD$471.93 [95% CI: -USD$21.17 to $965.02]).
UNASSIGNED: Although substantial increases occurred after injuries, with fracture and NFFI increasing similarly, changes in monthly spending after fall injury were not different compared to nonfall events. Our results contribute to the understanding of subsequent spending after fall injury that may inform further research on fall injury-related health care spending.
UNASSIGNED: The Health, Aging, and Body Composition Study included 1 595 community-dwelling adults (53% women, 37% Black; 76.7 ± 2.9 years) with linked Medicare Fee-For-Service (FFS) claims at 2000/01 exam. Incident outpatient and inpatient fall injuries (N = 448) from 2000/01 exam to December 31, 2008 were identified using the first claim with a nonfracture injury diagnosis code with a fall E-code, or a fracture diagnosis code with/without an E-code. Up to 3 participants without fall injuries (N = 1 147) were matched on nonfall events to 448 participants in the fall injury month. We calculated the change in monthly FFS spending in 12 months before versus after index events in both groups. Generalized linear regression with centered outcomes and gamma distributions examined the association of prepost expenditure changes with fall injuries (including NFFI and fractures) adjusting for related covariates.
UNASSIGNED: Monthly spending increased after versus before fall injuries (USD$2 261 vs $981), nonfracture (N = 105; USD$2 083 vs $1 277), and fracture (N = 343; USD$2 315 vs $890) injuries (all p < .0001). However, after adjusting for covariates in final models, fall injuries were not significantly associated with larger increases in spending/month versus nonfall events (differential increase: USD$399.58 [95% CI: -USD$44.95 to $844.11]). Fracture prepost change in monthly spending was similar versus NFFI (differential increase: USD$471.93 [95% CI: -USD$21.17 to $965.02]).
UNASSIGNED: Although substantial increases occurred after injuries, with fracture and NFFI increasing similarly, changes in monthly spending after fall injury were not different compared to nonfall events. Our results contribute to the understanding of subsequent spending after fall injury that may inform further research on fall injury-related health care spending.
摘要：
■跌倒伤害在老年人中普遍存在，然而,非骨折(NFFI)和骨折后是否出现更高的支出尚不清楚.我们检查了事故是否坠落受伤，包括NFFI和骨折，与老年人事件发生后12个月医疗保险支出增加相关.
■健康，衰老,和身体成分研究包括1.595社区居住的成年人(53%的女性，37%的黑人；76.7±2.9年)与2000/01年考试中的医疗保险按服务收费(FFS)索赔挂钩。从2000/01检查到2008年12月31日的门诊和住院事故跌倒伤害（N=448）是使用带有跌倒E代码的非骨折伤害诊断代码的第一项索赔确定的。或带有/不带有E代码的骨折诊断代码。多达3名没有跌倒损伤的参与者（N=1.147）在跌倒损伤月的非跌倒事件中与448名参与者进行匹配。我们计算了两组指数事件发生前12个月内每月FFS支出的变化。具有居中结果和伽马分布的广义线性回归检查了调整相关协变量后的术后支出变化与跌倒损伤（包括NFFI和骨折）的关联。
■受伤后与受伤前相比，每月支出有所增加（2.261美元对981美元），非骨折(N=105；2.083美元对1.277美元)，和骨折（N=343；2.315美元vs890美元）受伤（所有p<0.0001）。然而,在最终模型中调整协变量后，与非跌倒事件相比，跌倒伤害与支出/月的更大增长没有显着相关（差异增长：399.58美元[95％CI：-44.95美元至844.11美元]）。每月支出的骨折前变化与NFFI相似（差异增加：471.93美元[95％CI：-21.17美元至965.02美元]）。
■尽管受伤后出现了大幅增加，骨折和NFFI增加相似，与非跌倒事件相比,跌倒损伤后每月支出的变化没有差异.我们的研究结果有助于了解跌倒损伤后的后续支出，这可能会为进一步研究跌倒损伤相关的医疗保健支出提供信息。
■健康，衰老,和身体成分研究包括1.595社区居住的成年人(53%的女性，37%的黑人；76.7±2.9年)与2000/01年考试中的医疗保险按服务收费(FFS)索赔挂钩。从2000/01检查到2008年12月31日的门诊和住院事故跌倒伤害（N=448）是使用带有跌倒E代码的非骨折伤害诊断代码的第一项索赔确定的。或带有/不带有E代码的骨折诊断代码。多达3名没有跌倒损伤的参与者（N=1.147）在跌倒损伤月的非跌倒事件中与448名参与者进行匹配。我们计算了两组指数事件发生前12个月内每月FFS支出的变化。具有居中结果和伽马分布的广义线性回归检查了调整相关协变量后的术后支出变化与跌倒损伤（包括NFFI和骨折）的关联。
■受伤后与受伤前相比，每月支出有所增加（2.261美元对981美元），非骨折(N=105；2.083美元对1.277美元)，和骨折（N=343；2.315美元vs890美元）受伤（所有p<0.0001）。然而,在最终模型中调整协变量后，与非跌倒事件相比，跌倒伤害与支出/月的更大增长没有显着相关（差异增长：399.58美元[95％CI：-44.95美元至844.11美元]）。每月支出的骨折前变化与NFFI相似（差异增加：471.93美元[95％CI：-21.17美元至965.02美元]）。
■尽管受伤后出现了大幅增加，骨折和NFFI增加相似，与非跌倒事件相比,跌倒损伤后每月支出的变化没有差异.我们的研究结果有助于了解跌倒损伤后的后续支出，这可能会为进一步研究跌倒损伤相关的医疗保健支出提供信息。
