Ann Geriatr Med Res.  2019 Sep;23(3):115-124. 10.4235/agmr.19.0021.

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

• Kim HJ
• Jang SN
• Lee JK
• Ha YC

• KMID: 2464500
• DOI: http://doi.org/10.4235/agmr.19.0021

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.

Keyword

Fractures; Long-term care; Survival analysis; Frail elderly

MeSH Terms

Adult
Aged
Aging
Certification
Cohort Studies*
Frail Elderly
Humans
Incidence
Long-Term Care*
Lower Extremity
National Health Programs*
Proportional Hazards Models
Rehabilitation
Risk Factors
Survival Analysis