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. 2020 Jun 8;9(5):250-257.
doi: 10.1302/2046-3758.95.BJR-2019-0221.R1. eCollection 2020 May.

Utilization and costs of formal and informal care, home adaptations, and physiotherapy among older patients with hip fracture

M E Png  1 , X L Griffin  2 , M L Costa  2 , J Achten  2 , R Pinedo-Villanueva  2
Affiliations

Utilization and costs of formal and informal care, home adaptations, and physiotherapy among older patients with hip fracture

M E Png et al. Bone Joint Res. .

Abstract

Aims: This feasibility study investigates the utilization and cost of health resources related to formal and informal care, home adaptations, and physiotherapy among patients aged 60 years and above after hip fracture from a multicentre cohort study (World Hip Trauma Evaluation (WHiTE)) in the UK.

Methods: A questionnaire containing health resource use was completed at baseline and four months post-injury by patients or their carer. Completion rate and mean cost of each health resource item were assessed and sensitivity analysis was performed to derive a conservative estimate of the informal care cost. All costs are presented in 2017/18 pound sterling.

Results: A total of 4,183 patients from the WHiTE cohort completed the baseline questionnaire between May 2017 and April 2018, of whom 3,524 (84.2%) completed the four-month health resource section. Estimated mean costs of formal and informal care, home adaptations, and physiotherapy during the four months following injury were £2,843 (SD 5,467), £6,613 (SD 15,146), £706 (SD 1,706) and £9 (SD 33), respectively. Mean cost of informal care decreased to £660 (SD £1,040) in the sensitivity analysis when informal care was capped at 17.2 hours per day.

Conclusion: Informal care is a significant source of costs after hip fracture and should therefore be included in future economical analyses of this patient group. Our results show that there is considerable variation in the interpretation of time-use of informal care among patients and further work is needed to improve how data regarding informal care are collected in order to obtain a more accurate cost estimate.Cite this article: Bone Joint Res. 2020;9(5):250-257.

Keywords: Adaptation; Care; Cost; Hip fracture; Physiotherapy.

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Conflict of interest statement

Conflict of interest statement: X. L. Griffin reports consultancy fees from Synthes and Stryker, an institutional payment from Stryker for the development of educational presentations, employment payment from the University of Oxford, multiple institutional grants from NIHR Industry, multiple institutional payments for speaking engagements, and multiple travel/accommodation/meeting expenses, unrelated to this study. J. Acthen reports employment payment from the University of Oxford, unrelated to this study. M. Costa reports employment payment from the University of Oxford, and an institutional research grant from NIHR, the EU, RCS England and Industry, unrelated to this study. M. Costa is a NIHR Senior Investigator. The views expressed in this article are those of the author(s) and not necessarily those of the NIHR, or the Department of Health and Social Care.

Figures

Fig. 1
Fig. 1
Mean cost of each cost component during pre- and post-injury for base case and sensitivity analysis.
Fig. 2
Fig. 2
Frequency of the mean number of hours of informal care received per week during pre- and post-injury.
See this image and copyright information in PMC

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