Expedited Operative Care of Hip Fractures Results in Significantly Lower Cost of Treatment

Abstract

Background: There are an estimated 150,000 hip fractures per year in the United States, with estimated costs of care between $10.3 billion and $15.2 billion. With such high costs and an increasing burden of care, there has been interest in newer methods to increase efficiency of care. One such method is expedited fracture care, with earlier operative intervention. The purpose of this study was to determine if intervention within six hours of admission decreased costs with no change in the rate of major complications.

Methods: A retrospective review of all patients age >65 undergoing operative intervention for a proximal femur fracture over a two year period were identified. Patients were divided into two groups: those undergoing operative intervention < six hours after admission (early) and those undergoing operative intervention > six hours after admission. Patient age, average length of stay, and complication rates were determined for the two groups.

Results: Our study identified 657 patients, 111 of which underwent early intervention with the remaining 546 undergoing late intervention. The average length of stay for the early intervention group was 4.11 days, compared to 5.68 days for die late intervention group (p=0.0005). There was a significant difference in average cost between the two groups. The average cost of the early intervention was $49,900, with the average cost of late intervention being $65,300 (p = 0.0086). There was no significant difference in incidence of major complications between the two groups.

Conclusion: Programs emphasizing early intervention for hip fractures have the potential for large healthcare savings, with an average savings of $15,400.

Level of evidence: Level IV, therapeutic case series.