Post Fracture Oversight Persists in Osteoporosis

September 25, 2020

In a review recently published in Current Osteoporosis Reports, Sarah French, M.D., a rheumatologist with the University of California at San Francisco, summarizes performance quality measures for osteoporosis using Centers for Medicare and Medicaid measures for pay-for-performance programs. In this interview, Dr. French shares with us her findings.

In a review recently published in Current Osteoporosis Reports, Sarah French, M.D., a rheumatologist with the University of California at San Francisco, summarizes performance quality measures for osteoporosis using Centers for Medicare and Medicaid measures for pay-for-performance programs.

She reports having found a gradual improvement in osteoporosis screening, osteoporosis identification and treatment after a fragility fracture. Between 2006 and 2016, there was improvement in documentation of fall risk assessment and in the development of care plans for patients. However, population-based studies have suggested achievement for these process measures is lower where reporting is not mandated.

Performance gaps remain, particularly for post-fracture care. Elderly patients with increased comorbidity are especially vulnerable to fractures, yet the review finds under performance in this population. Gender and racial disparities also exist.

There are some fixes, such as education, but it's not enough to improve the quality of care patients receive. "Multi-factorial and systems-based interventions seem to be most successful in leading to measurable change for osteoporosis care and fall prevention. Despite increasing recognition of evidence-based quality measures for osteoporosis and incentives to improve upon performance for these measures, persistent gaps in care exist that will require further investigation into sustainable and value-adding quality improvement interventions," Dr. French writes.

In this interview, Dr. French shares with us her findings.

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REFERENCE

S French, S Choden, Gabriela Schmajuk. "Quality Measures and Quality Improvement Initiatives in Osteoporosis—an Update," Current Osteoporosis Reports. December 2019. DOI: 10.1007/s11914-019-00547-5