Geographic variation in the treatment of proximal humerus fracture: an update on surgery rates and treatment consensus

Table 1 Characteristics of 2011 Medicare proximal humerus fracture patients by treatment group

	Treatment group			p
	Total population	Surgical management	Conservative management	p
N	77,053	11,833	65,220
Patient demographics
Male, %	19.9	17.6	20.3	< 0.001
Mean age	80.3	78.1	80.7	< 0.001
Age group, %				< 0.001
66–69	13.0	16.9	12.3
70–75	20.5	25.5	19.6
76–79	14.9	17.6	14.4
80–85	24.8	24.0	25.0
86+	26.7	16.0	28.6
Race, %				< 0.001
Asian	0.9	0.7	1.0
Black	3.1	2.0	3.3
Hispanic	1.4	1.0	1.4
Other	1.2	1.1	1.2
White	93.4	95.1	93.1
Fully dual eligible¹, %	13.8	9.3	14.6	< 0.001
Charlson Comorbidity Index², %				< 0.001
0	24.4	28.9	23.6
1	20.2	21.5	20.0
2	15.5	15.0	15.6
3	12.4	12.1	12.4
4+	27.5	22.5	28.4
Frailty Risk Index (FRI)				< 0.001
0	34.1	41.4	32.8
1	25.9	26.8	25.7
2	15.9	14.7	16.1
3+	24.1	17.0	25.4
Shoulder diagnoses in the year prior to index fracture
Osteoarthritis	25.4	23.7	25.7	< 0.001
Rheumatoid arthritis	8.0	7.4	8.1	0.01
Rotator cuff arthropathy	6.6	6.3	6.6	0.15
Avascular necrosis	0.2	0.3	0.2	0.04
Previous year Medicare spending³	$15,623	$12,157	$16,252	< 0.001

Differences across groups assessed by the two sample independent t test for continuous variables and Pearson’s chi-square for categorical data
¹Beneficiary was fully dual-eligible for Medicare and Medicaid during the month of the index fracture
²Charlson Comorbidity Index
³Total Part A and B payments made by Medicare for the beneficiary over the period of 365 days prior to their index fracture date

ISSN: 1749-799X