Health resource utilization and outcomes were compared between matched cohorts using the McNemar chi-square test for categorical variables and the paired t test for continuous variables. Total costs were determined by summation of each costing component and presented as the mean cost over the first and second year. Attributable hip fracture costs were determined by subtracting costs in the non-hip fracture cohort from the costs in the matched hip fracture cohort [24]. Variance estimation (95 % CI) was determined using bootstrapping with replacement [24]. All costs were stratified
by resource type (acute hospitalization, same day surgery, emergency department, complex continuing care, rehabilitation, LTC, home care, physician services, prescriptions Cytoskeletal Signaling inhibitor for osteoporosis, and pain medications), sex, age group (66–69, 70–74,
75–79, 80–84, 85–89, 90+), and residence check details status (community or LTC) at baseline. In an effort to determine costs attributed to death from hip fracture, we further evaluated costs among concordant pairs who survived or died within 1- and 2-years of follow-up. One-year attributable hip fracture costs in Canada were estimated by multiplying sex-specific attributable mean costs in Ontario by 30,000—the total number of hip fractures estimated to occur annually in Canada [4, 25]. Results We identified 36,253 hip fracture patients, of which 31,064 see more (86 %) were eligible. Exclusions were primarily as a result of prior hip fracture (56 % females and 30 % males) and a diagnosis of malignant neoplasm (34 % females, 52 % males), Appendix Fig. 1. After applying exclusion criteria and identifying suitable non-hip fracture matches, the final cohort included 30,029 matched pairs (22,418 females, 7,611 males).
selleck kinase inhibitor Mean age at hip fracture was 83.3 years (SD = 7.1) for females and 81.3 years (SD = 7.1) for males (Table 1). About one-fifth (21 % females, 18 % males) of patients resided in LTC at the time of fracture. The sex-specific matched fracture and non-hip fracture cohorts were well balanced on matched variables, as well as on prior osteoporosis diagnosis. However, more hip fracture patients had been dispensed an osteoporosis medication or incurred a non-hip fracture in the year prior to fracture. Fig. 1 Study flow diagram for hip and non-hip fracture cohort inclusion. RPDB means registered persons database. Exclusions are not mutually exclusive and thus will not add to 100 % Table 1 Baseline characteristics of hip fracture cohort and matched non-hip fracture cohort Variable Value Females Males Hip fracture (N = 22,418) Non-hip fracture (N = 22,418) SD Hip fracture (N =7,611) Non-hip fracture (N = 7,611) SD N % N % N % N % Age Mean ± STD 83.3 ± 7.1 83.3 ± 7.1 0 81.3 ± 7.1 81.3 ± 7.1 0 66–69 869 3.9 869 3.9 0 483 6.3 483 6.3 0 70–74 1,893 8.4 1,893 8.4 0 940 12.4 940 12.4 0 75–79 3,564 15.9 3,564 15.9 0 1,624 21.3 1,624 21.