Chicago’s Wide Variance in Fracture Readmission Rates Indicates Opportunities for Osteoporosis Treatment

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In Tymlos, Osteoporosis

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By: James Pitt  Jul. 30, 2018

Osteoporosis is a common disease of aging, associated with weakened bones. Bone fractures are associated with higher subsequent mortality. According to University of Washington Medicine, “The one-year mortality following a hip fracture is 12 to 24%. It is estimated that 14% of deaths following a hip or pelvic fracture in previously ambulatory women were caused or hastened by the fracture.”

Repeated fractures are common. Both pharmaceutical and surgical treatment can reduce risk of repeated fracture. Surgical repair of osteoporosis fractures is challenging, due to the weakened bone. A 2003 review recommended that “Structural bone graft or other types of fillers can be used to fill voids when comminution prevents stable contact. Load-sharing fixation devices such as the sliding hip screw, intramedullary nail, antiglide plate, and tension band constructs are better alternatives for osteoporotic metaphyseal locations.” Newer implants developed specifically for fragile bone have improved treatment, according to a June 2018 presentation recorded in Annals of the Rheumatic Diseases.

To examine the potential need for more durable surgical repairs, Dexur analysts examined fracture readmission rates in women with and without osteoporosis in Chicago from 2013-2016, using CMS inpatient discharge data.

Fracture readmission rates varied greatly across hospitals. Overall 30-day fracture readmission rates with osteoporosis ranged from 1.02% at Northwestern Memorial Hospital to 3.13% at Advocate Illinois Masonic Medical Center.

Patients whose index admission was for an orthopedic complaint were more likely to be readmitted with fracture. This is of course unsurprising. However, the magnitude of variation in readmission rates for orthopedic patients is striking.

30-day fracture readmissions were highest at Advocate Illinois Masonic Medical Center. This may indicate a need for a different fracture treatment approach.

Rush University Medical Center had the lowest 30-day fracture readmission rate in orthopedic patients, at 0.71%. Osteoporosis patients at Rush were three times as likely to be readmitted with a fracture within 30 days as orthopedic patients overall, at 2.73% of discharges.

DEXUR PRO MEMBERS GET ACCESS TO:

1. Total Discharges ( Jan 2013 to Dec 2016 )
2. 30 Day Fracture Readmissions
3. 30 Day Fracture Readmission Rate (%)
4. State 30 Day Fracture Readmission Rate (%)
5. National 30 Day Fracture Readmission Rate (%)
6. % 30 Day Readmissions back to Same Hospital
7. 60 Day Fracture Readmissions
8. 60 Day Fracture Readmission Rate (%)
9. State 60 Day Fracture Readmission Rate (%)
10. National 60 Day Fracture Readmission Rate (%)
11. 90 Day Fracture Readmissions
12. 90 Day Fracture Readmission Rate (%)
13. State 90 Day Fracture Readmission Rate (%)
14. National 90 Day Fracture Readmission Rate (%)

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By osteoporosis status and index admission (all inpatient, surgical, non surgical, or orthopedic), from 2013-2016, for CMS inpatient discharges among women at the following hospitals:

1. Northwestern Memorial Hospital (Chicago, IL)
2. Rush University Medical Center (Chicago, IL)
3. Presence Saints Mary and Elizabeth Medical Center (Chicago, IL)
4. Presence Resurrection Medical Center (Chicago, IL)
5. Swedish Covenant Hospital (Chicago, IL)
6. Advocate Illinois Masonic Medical Center (Chicago, IL)

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