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. 2019 Sep;23(3):115-124.
doi: 10.4235/agmr.19.0021. Epub 2019 Sep 23.

Fracture Experiences and Long-Term Care Initiation among Older Population: Analysis of Korean National Health Insurance Service-Senior Cohort Study

Hye-Jin Kim  1 , Soong-Nang Jang  1 , Ja-Kyung Lee  1 , Yong-Chan Ha  2
Affiliations

Fracture Experiences and Long-Term Care Initiation among Older Population: Analysis of Korean National Health Insurance Service-Senior Cohort Study

Hye-Jin Kim et al. Ann Geriatr Med Res. 2019 Sep.

Abstract

Background: Long-term care is a burden on individuals, families, and society. It is important to find ways to delay the onset of disability to lessen the burden of long-term care in aging societies. Fracture is one of the risk factors that affect physical functions and make older people dependent. This study aimed to examine how much more often older adults who experienced fractures initiated long-term care compared to those who did not, and whether the risk of entering long-term care differed significantly by fracture site.

Methods: The analyses included insurants aged 65 years and over from the Korean National Health Insurance Service-senior cohort study (2002-2013). Cox proportional hazard models were used to calculate the hazard ratios of the first certification of initiation of long-term care after fracture, by fracture site, and for multiple recurrent fractures.

Results: The incidence rate of initial long-term care beneficiaries was approximately 2.5 times higher when older people had experienced fractures; these individuals entered long-term care beneficiary status 3 years earlier compared to those who had no fracture events. Lower extremity fracture and multiple recurrent fractures more than doubled the risk for long-term care.

Conclusion: Additional attention to fracture sites in prevention and rehabilitation settings is warranted to reduce disability and the related long-term care burden.

Keywords: Fractures; Frail elderly; Long-term care; Survival analysis.

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Conflict of interest statement

The researchers claim no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Long-term care (LTC) initiation among age, sex, and fracture sites in the Korean National Health Insurance Service-senior sample cohort (Kaplan–Meier survival curves). LTC initiation by fracture in men (A) and women (B). LTC initiation by fracture sites in men (C) and women (D). Upper fracture means upper extremity fracture and lower fracture means lower extremity fracture.
See this image and copyright information in PMC

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