Impact of a national reimbursement add-on policy on refracture risk and secondary fracture prevention after hip fracture in Japan: a population-based interrupted time series analysis
Main finding · 1-year cumulative risk of refracture, absolute effectResult — go to the resultAbsolute effect - 1.02 percentage points 95% CI - 1.44 to - 0.60Authors' conclusion
The reimbursement add-on policy for secondary fracture prevention after hip fracture surgery was associated with a lower 1-year cumulative refracture risk and a higher cumulative probability of receiving DXA assessment and initiating anti-osteoporosis medication, but not with improved 1-year post-fracture treatment persistence.
Study context
- Population
- Adults aged ≥ 50 years with newly identified and surgically treated hip fracture, Japan, 2019–2023
- Exposure
- After vs before implementation of the national reimbursement add-on policy (1 April 2022)
- Outcome
- Absolute change in the 1-year cumulative risk of first refracture
- Follow-up
- 12 months after policy implementation
Methodological detailspopulation-based, longitudinal health insurance claims data
- Population-based
- Longitudinal health insurance claims data
Main finding
As reported in the abstract
Absolute effect
- 1.02 percentage points
95% CI - 1.44 to - 0.60
Observational data: associations, not effects.
Further findings
90-day cumulative probability of receiving DXA assessment, absolute change · 12 months after policy implementation
- Absolute effect on DXA assessment, percentage points
- 41.37 (40.21 to 42.54) (95% CI)
120-day cumulative probability of initiating anti-osteoporosis medication, absolute change · 12 months after policy implementation
- Absolute effect on initiation of anti-osteoporosis medication, percentage points
- 22.83 (21.70 to 23.95) (95% CI)
1-year post-fracture treatment persistence, absolute change · 12 months after policy implementation
- Absolute effect on 1-year post-fracture treatment persistence, percentage points (95% CI)
- - 6.76 (- 10.04 to - 3.49)
Original publication
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