National Healthcare Disparities Report - LDI Health Economist

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Effectiveness of Care NEW Musculoskeletal Diseases Importance Chapter 2 Musculoskeletal Diseases Prevalence People diagnosed with arthritis, rheumatoid arthritis, lupus, or fibromyalgia (2007-2009) .............................................................50 million (22%) (MMWR, 2010a) Number of people with low bone density........................................................................34 million (NOF, 2011) Morbidity Activity limitations attributable to diagnosed arthritis among U.S. population (2007)..........................................................................................21 million (42%) (MMWR, 2010a) Lifetime osteoporosis-related fractures among women over age 50..........................approx. 50% (NOF, 2011) Lifetime osteoporosis-related fractures among men over age 50...............................approx. 25% (NOF, 2011) Cost Total cost of arthritis and other rheumatic conditions (2003) ...............................$128 billion (MMWR, 2007) Direct medical cost of arthritis and other rheumatic conditions (2003) .................$81 billion (MMWR, 2007) Indirect costs of arthritis and other rheumatic conditions (2003) ...........................$47 billion (MMWR, 2007) Total cost of osteoporosis-related fractures (2005) ........................................................$19 billion (NOF, 2011) Measures This section on musculoskeletal diseases is new in the 2011 NHQR and NHDR. It tracks several quality measures for prevention and management of this broad category of illnesses that includes osteoporosis and arthritis. One measure was moved from the section on functional status and highlighted here: n Osteoporosis screening among older women. In addition, three new measures related to the management of arthritis are shown. These measures are part of the Arthritis Foundation’s Quality Indicator Set for Osteoarthritis. A multidisciplinary panel of experts on arthritis and pain reviewed scientific evidence to help develop the Quality Indicator Set (Pencharz & MacLean, 2004). The measures were tracked as part of Healthy People 2010 and continue to be tracked in Healthy People 2020: n Arthritis education among adults with arthritis. n Counseling about physical activity among adults with arthritis. n Counseling about weight reduction among overweight adults with arthritis. 98 National Healthcare Disparities Report, 2011
Effectiveness of Care Findings Prevention: Osteoporosis Screening Among Older Women Osteoporosis is a disease characterized by loss of bone tissue. Osteoporosis increases the risk of fractures of the hip, spine, and wrist. About half of all postmenopausal women will experience an osteoporotic fracture. Osteoporotic fractures cause considerable morbidity and mortality. For example, of patients with hip fractures, one-fifth will die during the first year, one-third will require nursing home care, and only one-third will return to the functional status they had before the fracture. The remaining 13 percent have other outcomes (Lane, 2006). Because older women are at highest risk for osteoporosis, the U.S. Preventive Services Task Force recommends routine osteoporosis screening of women age 65 and over. Women with low bone density can reduce their risk of fracture and subsequent functional impairment by taking appropriate medications and engaging in weight-bearing exercise (USPSTF, 2002). Figure 2.35. Female Medicare beneficiaries age 65 and over who reported ever being screened for osteoporosis with a bone mass or bone density measurement, by race/ethnicity and income, 2000-2008 100 80 Total White Black Hispanic 100 80 Poor Low Income Middle Income High Income Chapter 2 Musculoskeletal Diseases 60 60 Percent 40 Percent 40 20 20 0 2000 2003 2006 2008 0 2000 2003 2006 2008 Source: Medicare Current Beneficiary Survey, 2000-2008. Denominator: Female Medicare beneficiaries age 65 and over living in the community. Note: White and Black groups are non-Hispanic; Hispanic includes all races. n From 2000 to 2008, the percentage of female Medicare beneficiaries age 65 and over who reported ever being screened for osteoporosis with a bone mass or bone density measurement increased from 34% to 71% (Figure 2.35). Improvements were observed among all racial/ethnic and income groups. n In all years, Hispanic and non-Hispanic Black women were less likely to be screened for osteoporosis than non-Hispanic White women. National Healthcare Disparities Report, 2011 99
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U.S. Department of Health and Human
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