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

Table 2 Characteristics of surgically managed Medicare proximal humerus fracture patients by surgical procedure

	Surgical procedure				p
	All	Hemi	ORIF	RSA	p
N	11,833	2644	7792	1397
Patient demographics
Male, %	17.6	14.7	18.8	16.7	< 0.001
Mean age	78.1	78.3	77.9	78.8	< 0.001
Age group, %					< 0.001
66–69	16.9	15.0	18.5	11.5
70–75	25.4	24.4	25.5	27.4
76–79	17.6	20.2	16.9	17.0
80–85	24.0	24.5	23.1	27.9
86+	16.0	15.8	16.1	16.2
Race, %					0.59
Asian	0.7	0.5	0.8	0.6
Black	2.0	1.6	2.1	2.4
Hispanic	1.0	1.1	1.0	1.1
Other	1.1	1.1	1.2	0.9
White	95.1	95.7	95.0	94.8
Fully dual eligible¹, %	9.3	9.2	9.7	7.2	0.01
Charlson Comorbidity Index², %					0.06
0	28.9	27.6	29.5	28.2
1	21.5	22.8	21.3	20.1
2	15.0	15.5	14.7	15.6
3	21.1	12.5	11.6	14.0
4+	22.5	21.6	22.9	22.1
Frailty Risk Index (FRI)					< 0.001
0	41.5	44.4	40.4	42.2
1	26.8	25.9	26.5	30.1
2	14.7	14.5	14.8	14.0
3+	17.0	15.2	18.2	13.7
Shoulder diagnoses in the year prior to index fracture
Osteoarthritis	23.7	22.6	23.1	29.3	< 0.001
Rheumatoid arthritis	7.4	6.8	7.4	8.7	0.09
Rotator cuff arthropathy	6.3	6.3	5.2	11.9	< 0.001
Avascular necrosis	0.3	0.4	0.2	0.4	0.08
Previous year Medicare spending³	$12,157	$11,269	$12,591	$11,417	0.008
Days to surgery²	7.9	8.5	7.0	11.3	< 0.001

Differences across groups assessed by ANOVA 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
²Days from index diagnosis date to surgery procedure date
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