Comparison of total costs between internal fixation and hemiarthroplasty for displaced femoral neck fractures

Abstract

Background: There is very little information on the costs of different surgeries for displaced femoral neck fractures. This study aimed to compare the costs between internal fixation and hemiarthroplasty (HA) in the treatment of displaced femoral neck fracture.

Method: A total of 142 patients aged 65 years or older who had been randomized into internal fixation group (n = 70) or HA group (n = 72) were followed for 2 years. Cost data was collected through hospitalization information, cost diary and telephone interview. Sensitivity analysis was performed for missing diaries. The total costs were collected and compared between the two groups.

Results: All diaries were completed by 69.7% of patients. The mean costs of primary treatment were significantly lower for internal fixation (CNY 21,631) compared with HA (CNY 51,641) (p < 0.001). The mean post-discharge costs were similar for both procedures: CNY 37,377 for internal fixation and CNY 34,981 for HA (p = 0.640). The mean total costs for internal fixation were CNY 59,008, which was significantly lower than the mean total costs of CNY 86,622 for HA (p = 0.002).

Conclusion: Although the post-discharge costs of internal fixation were slightly higher, the total costs were still lower than for HA due to great variance in costs of primary treatment. In China, internal fixation may be less costly than HA for displaced femoral neck fracture treatment.