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Clinical Orthopaedics and Related Research®

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01-07-2011 | Symposium: AAOS/ORS/ABJS Musculoskeletal Healthcare Disparities Research Symposium

Minimizing Disparities in Osteoporosis Care of Minorities With an Electronic Medical Record Care Plan

Authors: Ronald A. Navarro, MD, Denise F. Greene, RNP, Raoul Burchette, MS, Tadashi Funahashi, MD, Richard Dell, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 7/2011

Abstract

Background

Ethnic disparities in care have been documented with a number of musculoskeletal disorders including osteoporosis. We suggest a systems approach for ensuring osteoporosis care can minimize potential ethnic disparities in care.

Questions/purposes

We evaluated variations in osteoporosis treatment by age, sex, and race/ethnicity by (1) measuring the rates of patients after a fragility fracture who had been evaluated by dual-energy xray absorptiometry and/or in whom antiosteoporosis treatment had been initiated and (2) determining the rates of osteoporosis treatment in patients who subsequently had a hip fracture.

Patients and Methods

We implemented an integrated osteoporosis prevention program in a large health plan. Continuous screening of electronic medical records identified patients who met the criteria for screening for osteoporosis, were diagnosed with osteoporosis, or sustained a fragility fracture. At-risk patients were referred to care managers and providers to complete practice guidelines to close care gaps. Race/ethnicity was self-reported. Treatment rates after fragility fracture or osteoporosis treatment failures with later hip fracture were calculated. Data for the years 2008 to 2009 were stratified by age, sex, and race/ethnicity.

Results

Women (92.1%) were treated more often than men (75.2%) after index fragility fracture. The treatment rate after fragility fracture was similar among race/ethnic groups in either sex (women 87.4%–93.4% and men 69.3%–76.7%). Osteoporotic treatment before hip fracture was more likely in white men and women and Hispanic men than other race/ethnic and gender groups.

Conclusions

Racial variation in osteoporosis care after fragility fracture in race/ethnic groups in this healthcare system was low when using the electronic medical record identifying care gaps, with continued reminders to osteoporosis disease management care managers and providers until those care gaps were closed.

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Title: Minimizing Disparities in Osteoporosis Care of Minorities With an Electronic Medical Record Care Plan
Authors: Ronald A. Navarro, MD
Denise F. Greene, RNP
Raoul Burchette, MS
Tadashi Funahashi, MD
Richard Dell, MD
Publication date: 01-07-2011
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 7/2011
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-011-1852-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Minimizing Disparities in Osteoporosis Care of Minorities With an Electronic Medical Record Care Plan

Abstract

Background

Questions/purposes

Patients and Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/purposes

Patients and Methods

Results

Conclusions

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