Kaiser Permanente’s Healthy Bones Program Results in Reduction in Hip Fractures

Kaiser Permanente

According to recent information from the National OsteoporosisFoundationand the Office of the Surgeon General, osteoporosis is a major medical problem. The disease currently affects 8million women and 2 million men in the United States. Kaiser Southern California has a fully integrated Healthy Bones Program in place at all eleven of its medical centers. Using its electronic medical records system is capable of tracking dual X-ray absorptiometry scans, fragility fractures, and the medications used to treat or prevent osteoporosis, Kaiser’s multidisciplinary team prevented 970 hip fractures in calendar year 2007 (2544 hip fractures were predicted and the actual number was 1574), a reduction of 38.1%.

Excerpts from The Journal of Bone and Joint Surgery article:
http://www.ejbjs.org/cgi/content/full/91/Supplement_6/79

“According to recent information from the National OsteoporosisFoundationand the Office of the Surgeon General, osteoporosis is a major medical problem. The disease currently affects 8million women and 2 million men in the United States. An additional 34 million Americans have low bone mass. Each year, an estimated1.5 million individuals in the United States experience a fragility fracture secondary to osteoporosis, resulting in an annual cost of 18 billion dollars. With the rapidly aging U.S. population, the problem of osteoporosis is now reaching epidemic proportions. There are 75 million baby boomers entering the stage in their lives when they are most at risk for osteoporosis. One-half of all women and one-third of all men will sustain a fragility fracture during their lifetime.

Knowledge That What the Orthopaedic Surgeon Does Improves Bone Health

The literature has shown that orthopaedic surgeons have not done enough to aggressively diagnose and treat osteoporosis. It is important for orthopaedic surgeons to know that an aggressive osteoporosis disease-management program can decrease the rate of osteoporosis-related hip fractures by 25% to 50%. One such program is described below.

Background of the Kaiser Southern California Healthy Bones Program

Kaiser Southern California (Kaiser SCAL) is a health-maintenance organization in Southern California that is made up of eleven medical centers with 3.2 million members. Kaiser SCAL has an electronic medical records system that is capable of tracking dual X-ray absorptiometry scans, fragility fractures, and the medications used to treat or prevent osteoporosis. Kaiser SCAL has a fully integrated Healthy Bones Program in place at all eleven of its medical centers. The Healthy Bones Program was established by having orthopaedic surgeons serve as champions in a large multidisciplinary team comprised of healthcare providers from the following disciplines: endocrinology, family practice, internal medicine, rheumatology.

Results

Since the SCAL Healthy Bones Program was adopted, we have seen our annual dual X-ray absorptiometry scan utilization rate rise from 21,557 per year in 2002 to 78,262 per year in 2007, a 263% increase. The annual dual X-ray absorptiometry scan utilization rate in men was 1549 in 2002, and it increased to 15,700 per year by 2007, a 914% increase. The annual number of patients receiving anti-osteoporosis medications rose from 33,208 per year in 2002 to 84,155 per year in 2007, a 153% increase. The annual number of men who received anti-osteoporosismedications in 2002 was 2663, and that number increased to 9310 a year by 2007, a 250% increase. There was a large variation in the reduction in hip fracture rates at the eleven SCAL medical centers during the study period. The reduction in hip fracture rate varied from 31.0% to 54.3%. The overall hip fracture rate reduction was 38.1%. That translated into preventing 970 hip fractures in calendar year 2007 (2544 hip fractures were predicted and the actual number was 1574).

Keywords: Osteoporosis, Kaiser Permanente Southern California, Healthy Bones, electronic medical records, orthopaedic, bone loss, hip fractures, bone loss, multidisciplinary team

FOR MORE INFORMATION:

Jean Sud
Senior Manager, Public Policy & Communications
Kaiser Permanente, The Permanente Federation
1 Kaiser Plaza
Oakland, CA 94612
tel. 510.271.6317
Jean.L.Sud@kp.org
www.kaiserpermanente.org