Editor’s ChoiceRate of Bone Mineral Density Testing and Subsequent Fracture-Free Interval After Distal Forearm Fracture in the Medicare Population
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Materials and Methods
We examined the Medicare Standard Analytic File dataset using the PearlDiver application (PearlDiver Inc) from 2005 to 2014 to identify patients with distal forearm fractures. PearlDiver is a national database of insurance billing records that can be used to identify patients based on International Classification of Diseases–Ninth Revision (ICD-9) and Current Procedural Terminology billing codes. The Medicare Standard Analytic File dataset represents 5% of the Medicare population and contains
Results
A total of 46,992 patients were identified who had sustained a distal forearm fracture (Table 2). Females comprised 81% of the cohort; the largest single age group was aged 85 years and older. Twenty percent of patients had undergone a BMD scan within the previous 2 years. Only 5% of men had screening before fracture, compared with 24% of women (P < .05). The most common fracture billing code was ICD-9-D-81342, which represents a closed fracture of the distal end of radius alone. The annual
Discussion
This study found that Medicare patients are not being routinely assessed for osteoporosis after distal forearm fractures. Approximately 1 in 4 patients underwent screening at any time point and less than 1 in 10 underwent testing within 6 months of fracture. Males were particularly undertested. About 1 in 5 patients sustaining these fractures had a subsequent hip or vertebral fracture. On average, patients who underwent testing after distal forearm fracture had improved fracture-free interval
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