| Index Group | N | Medicare Group | |||||
|---|---|---|---|---|---|---|---|
| Rate of Diagnosis | Rate of Treatment | ||||||
| Prefracture n (%) | Postfracture n (%) | P Value | Prefracture n (%) | Postfracture n (%) | P Value | ||
| 50-59 years | |||||||
| Vertebral | – | – | – | – | – | – | – |
| Hip | – | – | – | – | – | – | – |
| NHNV | – | – | – | – | – | – | – |
| Multiple | – | – | – | – | – | – | – |
| 60-64 years | |||||||
| Vertebral | – | – | – | – | – | – | – |
| Hip | – | – | – | – | – | – | – |
| NHNV | – | – | – | – | – | – | – |
| Multiple | – | – | – | – | – | – | – |
| 65-69 years | |||||||
| Vertebral | 1,582 | 236 (14.9) | 511 (32.3) | < 0.001 | 185 (11.7) | 337 (21.3) | < 0.001 |
| Hip | 586 | 59 (10.1) | 157 (26.8) | < 0.001 | 51 (8.7) | 87 (14.8) | < 0.001 |
| NHNV | 7,442 | 654 (8.8) | 1,040 (14.0) | < 0.001 | 650 (8.7) | 768 (10.3) | < 0.001 |
| Multiple | 682 | 60 (8.8) | 121 (17.7) | < 0.001 | 51 (7.5) | 71 (10.4) | 0.0045 |
| 70-79 years | |||||||
| Vertebral | 3,932 | 789 (20.1) | 1,566 (39.8) | < 0.001 | 615 (15.6) | 1,027 (26.1) | < 0.001 |
| Hip | 1,739 | 213 (12.2) | 469 (27.0) | < 0.001 | 154 (8.9) | 242 (13.9) | < 0.001 |
| NHNV | 12,505 | 1,441 (11.5) | 2,343 (18.7) | < 0.001 | 1,271 (10.2) | 1,530 (12.2) | < 0.001 |
| Multiple | 1,322 | 180 (13.6) | 364 (27.5) | < 0.001 | 152 (11.5) | 207 (15.7) | < 0.001 |
| 80-89 years | |||||||
| Vertebral | 2,336 | 566 (24.2) | 1,108 (47.4) | < 0.001 | 446 (19.1) | 675 (28.9) | < 0.001 |
| Hip | 1,390 | 203 (14.6) | 473 (34.0) | < 0.001 | 132 (9.5) | 196 (14.1) | < 0.001 |
| NHNV | 4,750 | 711 (15.0) | 1,130 (23.8) | < 0.001 | 630 (13.3) | 735 (15.5) | < 0.001 |
| Multiple | 805 | 155 (19.3) | 304 (37.8) | < 0.001 | 99 (12.3) | 142 (17.6) | < 0.001 |
| ≥ 90 yearsa | |||||||
| Vertebral | 1,615 | 447 (27.7) | 797 (49.3) | < 0.001 | 325 (20.1) | 465 (28.8) | < 0.001 |
| Hip | 1,309 | 189 (14.4) | 526 (40.2) | < 0.001 | 133 (10.2) | 205 (15.7) | < 0.001 |
| NHNV | 2,960 | 503 (17.0) | 828 (28.0) | < 0.001 | 376 (12.7) | 428 (14.5) | < 0.001 |
| Multiple | 648 | 130 (20.1) | 275 (42.4) | < 0.001 | 80 (12.3) | 110 (17.0) | < 0.001 |
| Index Group | Commercial Group | ||||||
| N | Rate of Diagnosis | Rate of Treatment | |||||
| Prefracture n (%) | Postfracture n (%) | P Value | Prefracture n (%) | Postfracture n (%) | P Value | ||
| 50-59 years | |||||||
| Vertebral | 2,045 | 116 (5.7) | 328 (16.0) | < 0.001 | 130 (6.4) | 251 (12.3) | < 0.001 |
| Hip | 527 | 28 (5.3) | 71 (13.5) | < 0.001 | 32 (6.1) | 55 (10.4) | < 0.001 |
| NHNV | 22,828 | 727 (3.2) | 1,195 (5.2) | < 0.001 | 1,048 (4.6) | 1,248 (5.5) | < 0.001 |
| Multiple | 1,568 | 40 (2.6) | 111 (7.1) | < 0.001 | 54 (3.4) | 75 (4.8) | 0.0038 |
| 60-64 years | |||||||
| Vertebral | 1,321 | 121 (9.2) | 279 (21.1) | < 0.001 | 144 (10.9) | 225 (17.0) | < 0.001 |
| Hip | 440 | 34 (7.7) | 82 (18.6) | < 0.001 | 38 (8.6) | 48 (10.9) | 0.0872 |
| NHNV | 11,519 | 641 (5.6) | 975 (8.5) | < 0.001 | 982 (8.5) | 1,089 (9.5) | < 0.001 |
| Multiple | 797 | 41 (5.1) | 88 (11.0) | < 0.001 | 67 (8.4) | 78 (9.8) | 0.169 |
| 65-69 years | |||||||
| Vertebral | 503 | 64 (12.7) | 149 (29.6) | < 0.001 | 78 (15.5) | 116 (23.1) | < 0.001 |
| Hip | 186 | 14 (7.5) | 34 (18.3) | < 0.001 | 22 (11.8) | 22 (11.8) | 1.000 |
| NHNV | 3,342 | 235 (7.0) | 338 (10.1) | < 0.001 | 347 (10.4) | 367 (11.0) | 0.123 |
| Multiple | 227 | 16 (7.0) | 34 (15.0) | 0.0014 | 22 (9.7) | 29 (12.8) | 0.1435 |
| 70-79 years | |||||||
| Vertebral | 775 | 137 (17.7) | 299 (38.6) | < 0.001 | 177 (22.8) | 252 (32.5) | < 0.001 |
| Hip | 380 | 55 (14.5) | 99 (26.1) | < 0.001 | 59 (15.5) | 73 (19.2) | 0.0385 |
| NHNV | 2774 | 328 (11.8) | 437 (15.8) | < 0.001 | 408 (14.7) | 425 (15.3) | 0.2567 |
| Multiple | 283 | 35 (12.4) | 68 (24.0) | < 0.001 | 49 (17.3) | 62 (21.9) | 0.0351 |
| 80-89 years | |||||||
| Vertebral | 1,155 | 261 (22.6) | 550 (47.6) | < 0.001 | 308 (26.7) | 399 (34.5) | < 0.001 |
| Hip | 852 | 106 (12.4) | 244 (28.6) | < 0.001 | 104 (12.2) | 131 (15.4) | 0.005 |
| NHNV | 2,203 | 330 (15.0) | 516 (23.4) | < 0.001 | 419 (19.0) | 426 (19.3) | 0.6575 |
| Multiple | 420 | 83 (19.8) | 133 (31.7) | < 0.001 | 93 (22.1) | 85 (20.2) | 0.280 |
| ≥ 90 years | |||||||
| Vertebral | – | – | – | – | – | – | – |
| Hip | – | – | – | – | – | – | – |
| NHNV | – | – | – | – | – | – | – |
| Multiple | – | – | – | – | – | – | – |
aFor all age strata except this one in the Medicare group, the prefracture to postfracture increase in diagnosis rate is greatest for vertebral fracture. In this age group, hip fracture had the greatest differential.
NHNV = nonhip/nonvertebral.