Evidence map›Paper›PMID 35370108›Full record

ArticleDisability and health journal2022

Excess healthcare spending associated with fractures among adults with cerebral palsy.

Daniel G Whitney, Michelle S Caird, Karl J Jepsen, Edward A Hurvitz, Richard A Hirth

Open access · greenAbstract read
In one paragraph

Article in Disability and health journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.3field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Daniel G WhitneyDepartment of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, USA. Electronic address: dgwhit@med.umich.edu.
Michelle S CairdDepartment of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.
Karl J JepsenDepartment of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.
Edward A HurvitzDepartment of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, USA.
Richard A HirthInstitute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, USA; Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA; Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
University of Michigan–Ann Arbor · US

Funding

Addressing knowledge gaps by multi-level research design to optimize clinical trial development in order to reduce fracture burden for adults with neurodevelopmental disabilitiesR01AR076994 · NIAMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HURVITZ, EDWARD A · 2021 to 2023
$616k
NIAMS NIH HHS R01 AR076994
6 · The paper itself

Abstract

backgroundFractures represent a triple threat to adults with cerebral palsy (CP): common, accumulate early in adulthood, and are consequential to health. An economic evaluation of fractures in CP is needed to highlight priorities for allocating resources to clinical and public health programs aimed at preventing fractures and their disease sequela.

objectiveTo identify short-term healthcare costs associated with fractures among adults with CP.

methodsA retrospective cohort study was performed using Optum's de-identified Clinformatics® Data Mart Database from 01/01/2011-12/31/2017. The primary cohort included adults ≥ 18 years old with CP with an incident fracture (CP+Fx), and cost estimates were compared with: CP without fractures (CPw/oFx) and without CP+Fx (w/oCP+Fx). A difference-in-difference (DiD) analysis compared the change in pharmacy and medical costs between cohorts from the one-year baseline period through the one-year post-index period in three-month quarters.

resultsCP+Fx (n = 855) had higher mean costs in the baseline and follow-up periods compared with CPw/oFx (n = 5667) and w/oCP+Fx (n = 588,042). The first post-index quarter DiD estimate suggests that CP+Fx accumulated an excess $6462 (95%CI = $3810-$9021) compared with w/oCP+Fx and $17,197 (95%CI = $14,418-$19,833) compared with CPw/oFx. The CP+Fx cohort had higher DiD estimates in the other follow-up quarters, but they were not statistically significant compared with CPw/oFx. When stratified by fracture site, vertebral column fractures for CP+Fx vs. w/oCP+Fx accumulated an excess $25,226 (95%CI = $12,639-$37,417).

conclusionsFractures, especially of the vertebral column, were associated with high healthcare costs among adults with CP. Studies are needed to identify cost-effective opportunities to utilize available resources to prevent fractures and their costly sequela for CP.

Indexed as

Cerebral PalsyFractures, BonePersons with DisabilitiesAdolescentAdultHealth Care CostsHumansRetrospective StudiesCerebral palsyClinical epidemiologyEconomicFractureHealthcare costs

Identifiers

PMID35370108
PMCPMC9308651
OpenAlexW4221137507

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.