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. 2016 Feb;27(2):549-58.
doi: 10.1007/s00198-015-3277-9. Epub 2015 Aug 19.

Impact of hip fracture on hospital care costs: a population-based study

J Leal  1 , A M Gray  2 , D Prieto-Alhambra  3   4   5 , N K Arden  3   4 , C Cooper  3   4 , M K Javaid  3   4 , A Judge  3   4 ; REFReSH study group
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Impact of hip fracture on hospital care costs: a population-based study

J Leal et al. Osteoporos Int. 2016 Feb.

Abstract

Using a large cohort of hip fracture patients, we estimated hospital costs to be £14,163 and £2139 in the first and second year following fracture, respectively. Second hip and non-hip fractures were major cost drivers. There is a strong economic incentive to identify cost-effective approaches for hip fracture prevention.

Introduction: The purpose of this study was to estimate hospital costs of hip fracture up to 2 years post-fracture and compare costs before and after the index fracture.

Methods: A cohort of patients aged over 60 years admitted with a hip fracture in a UK region between 2003 and 2013 were identified from hospital records and followed until death or administrative censoring. All hospital records were valued using 2012/2013 unit costs, and non-parametric censoring methods were used to adjust for censoring when estimating average annual costs. A generalised linear model examined the main predictors of hospital costs.

Results: A cohort of 33,152 patients with a hip fracture was identified (mean age 83 years (SD 8.2). The mean censor-adjusted 1- and 2-year hospital costs after index hip fracture were £14,163 (95 % confidence interval (CI) £14,008 to £14,317) and £16,302 (95 % CI £16,097 to £16,515), respectively. Index admission accounted for 61 % (£8613; 95 % CI £8565 to £8661) of total 1-year hospital costs which were £10,964 higher compared to the year pre-event (p < 0.001). The main predictors of 1-year hospital costs were second hip fracture, other non-hip fragility fractures requiring hospitalisation and hip fracture-related complications. Total UK annual hospital costs associated with incident hip fractures were estimated at £1.1 billion.

Conclusions: Hospital costs following hip fracture are high and mostly occur in the first year after the index hip fracture. Experiencing a second hip fracture after the index fracture accounted for much of the increase in costs. There is a strong economic incentive to prioritise research funds towards identifying the best approaches to prevent both index and subsequent hip fractures.

Keywords: Burden; Cost; Epidemiology; Health economics; Hip fracture; Osteoporosis.

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Figures

Fig. 1
Fig. 1
Hospitalisation costs in the months before and after primary hip fracture. Legend: *Complete cases, including those who died in that year
See this image and copyright information in PMC

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