PTOTSLPCohortDisability and health journal2022

Excess healthcare spending associated with fractures among adults with cerebral palsy.

Daniel G Whitney, Michelle S Caird, Karl J Jepsen and 2 others

PMID 35370108

WHAT IT FOUND

Adults with cerebral palsy who fracture incur excess healthcare costs, largely in the first three months.

Vertebral column fractures drove the highest costs for this group, unlike hip fractures in the general population. This highlights a critical window for post-fracture intervention.

Key findings

01Fractures in adults with cerebral palsy were associated with excess healthcare costs, particularly in the first quarter after the injury.

02Vertebral column fractures incurred disproportionately higher costs for adults with cerebral palsy compared to those without, whereas hip fracture costs were similar between groups.

03The study did not find statistically significant excess pharmacy costs for adults with cerebral palsy compared to controls in the main analysis.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

The study used a privately insured cohort, which likely represents a healthier, higher-functioning segment of the CP population, potentially underestimating the true cost burden. Follow-up was limited to one year, which may miss longer-term cost accumulation and health declines. The requirement for at least three months of post-fracture enrollment may have excluded patients with the most severe outcomes, including early mortality. The difference-in-difference analysis assumes parallel trends in costs before the fracture, which was not fully met when comparing CP patients with and without fractures.

Declared interests

The authors declared no conflicts of interest.

The easy way to misread this

Do not assume that hip fractures are the most costly event for adults with cerebral palsy. This study found that vertebral column fractures incurred the greatest excess costs for this population, differing from the general adult population where hip fractures are typically the most expensive.

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