Impact of the new reimbursement for secondary fracture prevention on inter-hospital variation in osteoporosis treatment for hip fracture patients: A nationwide analysis using DPC data
Authors' conclusion
The management fee functioned as an incentive for secondary fracture prevention, but its impact was uneven and increased inter-hospital disparities. Achieving equitable secondary fracture prevention may require a comprehensive approach that provides not only uniform financial incentives but also targeted support for hospitals with limited resources.
Study context
- Population
- Hip fracture patients in hospitals participating in the Quality Indicator/Improvement Project, Japan, Diagnosis Procedure Combination data (April 2020-March 2024)patients, in 168 hospitals
- Participants
- 76,111 patients
- Comparison
- Introduced vs non-introduced hospitals, before and after the management fee established in April 2022
- Introduced hospitalsn = 143
- Non-introduced hospitalsn = 25
- Outcome
- Osteoporosis medication prescription proportion
Methodological detailslogistic mixed-effects model, generalized estimating equations
- Logistic mixed-effects model
- Generalized estimating equations
Main finding
As reported in the abstract
Introduced hospitals: increased from 30.9% to 71.8%
30.9% to 71.8%
Non-introduced hospitals: remained at ≈20%
≈20%
Further findings
Inter-hospital variation (median odds ratio) in introduced hospitals
- Median odds ratio before
- 2.66 (95% confidence interval 2.39-3.03)
- Median odds ratio after
- 3.39 (2.96-4.00)
- Increased significantly, indicating increased inter-hospital variation
Hospital factors and the management fee's effectiveness
- Effectiveness significantly lower in rural and private hospitals and those with low surgical volumes
Original publication
Impact of the new reimbursement for secondary fracture prevention on inter-hospital variation in osteoporosis treatment for hip fracture patients: A nationwide analysis using DPC data. Osteoporos Int. Published 14 November 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →