| Demographic Group: | Medicare-eligible resident persons aged >=65 years. |
| Numerator: | Hospitalizations (not unduplicated*) with an International Classification of Diseases (ICD)-9-CM code 820 (search all diagnostic fields) among Medicare-eligible persons aged >=65 years among residents during a calendar year. |
| Denominator: | Residents aged >=65 years who were eligible for Medicare Part A benefits on July 1 of the calendar year, excluding members of health maintenance organizations. |
| Measures of Frequency: | Annual number of hospitalizations. Annual hospitalization rate — crude and age-adjusted (standardized by the direct method to the year 2000 standard U.S. population, distribution 1†) — with 95% confidence interval. |
| Time Period of Case Definition: | Calendar year. |
| Background: | Approximately 300,000 hip fractures occur each year in the United States. In 2003, the hip fracture rate for women was 85% higher than for men. Approximately 10 million U.S. residents have osteoporosis. |
| Significance: | Hip fracture is the most serious consequence of osteoporosis. The risk of osteoporosis and its complications might be reduced through physical activity, proper nutrition (i.e., adequate calcium and vitamin D intake through food or supplementation), and pharmacologic therapy. |
| Limitations of Indicator: | Hip fracture is a proxy measure for osteoporosis. Although 80%–90% of hip fractures are associated with osteoporosis, all hip fractures are not related to osteoporosis. Because osteoporosis is a chronic disease, years might pass before changes in patient behavior or clinical practice affect hospitalization for hip fracture. Indicator excludes younger persons who are at risk for osteoporosis (e.g., as a result of steroid treatment or early menopause). |
| Data Resources: | Centers for Medicare and Medicaid Services (CMS) Part A claims data (numerator) and CMS estimates of the population of persons eligible for Medicare (denominator).
|
| Limitations of Data Resources: | Diagnoses listed on hospital discharge data might be inaccurate. Practice patterns and payment mechanisms might affect decisions by health-care providers to hospitalize patients. Indicator is limited to Medicare-eligible population. |
| Healthy People 2010 Objectives: | 15-28: Reduce hip fractures among older adults. (15-28a is specific for females aged >=65 years; 15-28b is specific for males aged >=65 years.) |
