Emmanuel Papadimitropoulos

Economic implications of hip fracture: health service use, institutional care and cost in Canada.

Abstract: As the burden of illness associated with hip fracture extends beyond the initial hospitalization, a longitudinal 1 year cohort study was used to analyze levels of health service use, institutional care and their associated costs, and to examine patient and residency factors contributing to overall 1 year cost. Patients in the study were aged 50 year and over, and had been admitted to an acute care facility for hip fracture in the Hamilton–Wentworth region of Canada from 1 April 1995 to 31 March 1996. Health care resources assessed included initial hospitalization, rehospitalization, rehabilitation, chronic care, home care, long-term care (LTC) and informal care. Regression analysis was used to determine the effects of age, gender, residence, survival and days of follow-up on 1 year cost. The mean 1 year cost of hip fracture for the 504 study patients was 26.527 Canadian dollars (95% Cl:

Relation between fractures and mortality: results from the Canadian Multicentre Osteoporosis Study

24.564–

The influence of osteoporotic fractures on health-related quality of life in community-dwelling men and women across Canada.

28.490). One year costs were significantly different for patients who returned to the community (

The association between osteoporotic fractures and health-related quality of life as measured by the Health Utilities Index in the Canadian Multicentre Osteoporosis Study (CaMos)

21.385), versus those who were transferred to (

Mortality, Independence in Living, and Re-fracture, One Year Following Hip Fracture in Canadians

44.156), or readmitted to LTC facilities (

Vertebral fracture status and the world health organization risk factors for predicting osteoporotic fracture risk.

33.729) (p<0.001). Initial hospitalization represented 58% of 1 year cost for community-dwelling patients, compared with 27% for LTC residents. Only 59.4% of community-dwelling patients resided in the community 1 year following hip fracture, and 5.6% of patients who survived their first fracture experienced a subsequent hip fracture. Linear regression indicated place of residence, age and survival were all important contributors to 1 year cost (p<0.001). While the average 1 year cost of care was

Impact of Infectious Disease Consultation on the Clinical and Economic Outcomes of Solid-Organ Transplant Recipients Admitted for Infectious Complications

26.527, the overall cost varied depending on a patient”s place of residence, age, and survival to 1 year. Annual economic implications of hip fracture in Canada are

Delay of Adequate Empiric Antibiotic Therapy Is Associated with Increased Mortality among Solid‐Organ Transplant Patients

650 million and are expected to rise to

The burden of osteoporotic fractures beyond acute care: the Canadian Multicentre Osteoporosis Study (CaMos)

2.4 billion by 2041.

Clinical and microbiological epidemiology of early and late infectious complications among solid-organ transplant recipients requiring hospitalization

Background: Fractures have largely been assessed by their impact on quality of life or health care costs. We conducted this study to evaluate the relation between fractures and mortality. Methods: A total of 7753 randomly selected people (2187 men and 5566 women) aged 50 years and older from across Canada participated in a 5-year observational cohort study. Incident fractures were identified on the basis of validated self-report and were classified by type (vertebral, pelvic, forearm or wrist, rib, hip and “other”). We subdivided fracture groups by the year in which the fracture occurred during follow-up; those occurring in the fourth and fifth years were grouped together. We examined the relation between the time of the incident fracture and death. Results: Compared with participants who had no fracture during follow-up, those who had a vertebral fracture in the second year were at increased risk of death (adjusted hazard ratio [HR] 2.7, 95% confidence interval [CI] 1.1–6.6); also at risk were those who had a hip fracture during the first year (adjusted HR 3.2, 95% CI 1.4–7.4). Among women, the risk of death was increased for those with a vertebral fracture during the first year (adjusted HR 3.7, 95% CI 1.1–12.8) or the second year of follow-up (adjusted HR 3.2, 95% CI 1.2–8.1). The risk of death was also increased among women with hip fracture during the first year of follow-up (adjusted HR 3.0, 95% CI 1.0–8.7). Interpretation: Vertebral and hip fractures are associated with an increased risk of death. Interventions that reduce the incidence of these fractures need to be implemented to improve survival.