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Table 4 Medicare proximal humerus fracture patient characteristics by local area HRR surgical management quintiles

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

  Quintiles of surgical management area treatment ratios p
Total population 1 2 3 4 5
N 77,053 15,675 15,648 15,125 15,831 14,774  
Surgical management average area treatment ratio 1 0.65 0.88 0.98 1.13 1.36  
Average surgery rate, % 15.4 9.9 13.7 15.1 17.2 21.1  
Patient demographics
 Male, % 19.9 20.3 19.8 19.8 19.7 19.8 0.27
 Mean age 80.3 80.6 80.2 80.1 80.3 80.0 < 0.001
 Age group, %
  66–69 13.0 12.1 13.6 13.0 13.3 13.0  
  70–75 20.5 19.4 20.4 21.1 20.1 21.7  
  76–79 14.9 15.0 14.8 15.0 14.6 15.3  
  80–85 24.8 25.4 24.1 25.1 25.0 24.5  
  86+ 26.7 28.0 27.1 25.7 27.1 25.6  
 Race, %        0.04
  Asian 0.9 0.8 0.8 0.9 1.6 0.4  
  Black 3.1 2.6 3.3 3.1 3.4 3.3  
  Hispanic 1.4 1.0 1.1 2.1 1.5 1.0  
  Other 1.2 1.2 1.3 1.4 1.4 0.8  
  White 93.4 94.4 93.6 92.4 92.1 94.5  
 Fully dual eligible1, % 13.8 15.5 12.5 14.1 15.4 11.1 < 0.001
 Charlson Comorbidity Index2, %
  0 24.4 23.9 25.8 23.6 25.2 23.6 0.42
  1 20.2 20.1 20.5 20.1 20.5 19.9 0.62
  2 15.5 15.2 15.7 15.9 15.3 15.5 0.92
  3 12.4 12.5 12.0 12.5 12.0 12.8 0.58
  4+ 27.5 28.2 26.0 28.0 26.9 28.2 0.45
 Frailty Risk Index (FRI)
  0 34.1 33.8 35.2 34.2 34.2 33.2 0.09
  1 25.9 26.2 26.0 25.5 25.5 26.3 0.62
  2 15.9 16.1 15.5 15.6 15.8 16.3 0.65
  3+ 24.1 23.8 23.3 24.7 24.5 24.3 0.04
Shoulder diagnoses in the previous 365 days
 Osteoarthritis 25.4 24.3 24.0 26.0 26.0 26.9 < 0.001
 Rheumatoid arthritis 8.0 8.4 7.6 8.4 7.6 7.9 0.12
 Rotator cuff arthropathy 6.6 6.6 6.3 6.2 6.2 7.5 0.02
 Avascular necrosis 0.2 0.2 0.2 0.1 0.2 0.2 0.81
Previous year Medicare spending3 $15,623 $16,279 $14,831 $15,738 $15,581 $15,692 < 0.001
  1. Cochrane-Armitage used to asses trends across ATR quintiles
  2. 1Beneficiary was fully dual-eligible for Medicare and Medicaid during the month of the index fracture
  3. 2Charlson Comorbidity Index
  4. 3Total Part A and B payments made by Medicare for the beneficiary over the period of 365 days prior to their index fracture date