Journal of Community Health

, Volume 42, Issue 6, pp 1111–1117 | Cite as

Exploring Racial, Gender, and Insurance Disparities in Patients with Osteoporotic Fractures

  • Sarah C. DeShields
  • Cynthia C. Romero
  • Tina D. Cunningham
Original Paper


The objective of this study is to examine racial, gender, and insurance disparities in hospital outcomes among patients diagnosed with osteoporotic fractures aged 55 years and older. A total of 36,153 patients were included in this study. The sample was constructed from de-identified patient-level data for 2011 through 2014 from the Virginia Health Information (VHI) inpatient discharge database. Differences in mortality and 30-day readmission across race, gender, and insurance status were examined using logistic regression and generalized linear models for hospital charges and length of stay. Whites and Asians had a shorter stay than Blacks [5.2 days (95% confidence interval (CI) 5.1–5.3) and 5.0 days (95% CI 4.7–5.2) vs. 5.6 days (95% CI 5.4–5.7)], while Hispanics had a significantly longer stay [6.0 days (95% CI 5.6–6.5)]. On average, total charges were the highest among Blacks [$37,916 (95% CI 36,784–39,083)]. All outcomes were poorer for men than women. Privately and publicly insured patients were more likely to be readmitted [odds ratio (OR) 1.6 (95% CI 1.0-2.6) and OR 2.0 (95% CI 1.3–3.2)] and had a shorter stay than the uninsured [4.9 days (95% CI 4.8–5.0) and 5.2 days (95% CI 5.1–5.3) vs. 5.7 days (95% CI 5.4–6.0)], while privately insured patients had considerably lower total charges than those who were uninsured [$34,163 (95% CI 33,214–35,139) vs. $36,335 (95% CI 34,334–38,452)]. As evidenced from this study, there are racial, gender, and insurance disparities in health outcomes. These results and further exploration of these disparities could provide information necessary for strategies to improve these outcomes in at-risk patients diagnosed with osteoporotic fractures.


Disparities Osteoporotic fractures Hospitalizations Hospital outcomes 


Compliance with Ethical Standards

Conflict of interest

Sarah C. DeShields, Cynthia C. Romero, and Tina D. Cunningham declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Sarah C. DeShields
    • 1
  • Cynthia C. Romero
    • 2
    • 3
    • 4
  • Tina D. Cunningham
    • 1
    • 2
    • 5
    • 6
  1. 1.The Center for Health Analytics and DiscoveryEastern Virginia Medical SchoolNorfolkUSA
  2. 2.Graduate Program in Public HealthEastern Virginia Medical SchoolNorfolkUSA
  3. 3.M. Foscue Brock Institute for Community & Global HealthEastern Virginia Medical SchoolNorfolkUSA
  4. 4.Department of Family and Community MedicineEastern Virginia Medical SchoolNorfolkUSA
  5. 5.Master of Healthcare Delivery Science ProgramEastern Virginia Medical SchoolNorfolkUSA
  6. 6.Department of Internal MedicineEastern Virginia Medical SchoolNorfolkUSA

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