Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan 1;106-B(1):62-68.
doi: 10.1302/0301-620X.106B1.BJJ-2023-0740.R1.

The impact of an ageing population on future increases in hip fracture burden

Euan Harris  1 , Nick Clement  2   3   4 , Alasdair MacLullich  2   3   4 , Luke Farrow  2   5   6
Affiliations

The impact of an ageing population on future increases in hip fracture burden

Euan Harris et al. Bone Joint J. .

Abstract

Aims: Current levels of hip fracture morbidity contribute greatly to the overall burden on health and social care services. Given the anticipated ageing of the population over the coming decade, there is potential for this burden to increase further, although the exact scale of impact has not been identified in contemporary literature. We therefore set out to predict the future incidence of hip fracture and help inform appropriate service provision to maintain an adequate standard of care.

Methods: Historical data from the Scottish Hip Fracture Audit (2017 to 2021) were used to identify monthly incidence rates. Established time series forecasting techniques (Exponential Smoothing and Autoregressive Integrated Moving Average) were then used to predict the annual number of hip fractures from 2022 to 2029, including adjustment for predicted changes in national population demographics. Predicted differences in service-level outcomes (length of stay and discharge destination) were analyzed, including the associated financial cost of any changes.

Results: Between 2017 and 2021, the number of annual hip fractures increased from 6,675 to 7,797 (15%), with a rise in incidence from 313 to 350 per 100,000 (11%) for the at-risk population. By 2029, a combined average projection forecast the annual number of hip fractures at 10,311, with an incidence rate of 463 per 100,000, representing a 32% increase from 2021. Based upon these projections, assuming discharge rates remain constant, the total overall length of hospital stay following hip fracture in Scotland will increase by 60,699 days per annum, incurring an additional cost of at least £25 million per year. Approximately five more acute hip fracture beds may be required per hospital to accommodate this increased activity.

Conclusion: Projection modelling demonstrates that hip fracture burden and incidence will increase substantially by 2029, driven by an ageing population, with substantial implications for health and social care services.

PubMed Disclaimer

Conflict of interest statement

L. Farrow, N. Clement, and A. MacLullich are part of the Scottish Hip Fracture Audit (SHFA) Steering Committee, which provided the data for the submitted work. L. Farrow is currently in receipt of a Chief Scientist Office Scotland Clinical Academic Fellowship, which is unrelated to the submitted work.

References

    1. Ponkilainen V , Kuitunen I , Liukkonen R , Vaajala M , Reito A , Uimonen M . The incidence of musculoskeletal injuries: a systematic review and meta-analysis . Bone Joint Res . 2022 ; 11 ( 11 ): 814 – 825 . 10.1302/2046-3758.1111.BJR-2022-0181.R1 36374291
    1. Sugand K , Ali R , Goodall R , et al. Trends in neck of femur fracture incidence in EU15+ countries from 1990-2017 . Injury . 2023 ; 54 ( 2 ): 645 – 651 . 10.1016/j.injury.2022.11.038 36456215
    1. Kanis JA , Odén A , McCloskey EV , et al. A systematic review of hip fracture incidence and probability of fracture worldwide . Osteoporos Int . 2012 ; 23 ( 9 ): 2239 – 2256 . 10.1007/s00198-012-1964-3 22419370
    1. Cram P . CORR Insights®: What was the epidemiology and global burden of disease of hip fractures from 1990 to 2019? Results from and additional analysis of the Global Burden of Disease Study 2019 . Clin Orthop Relat Res . 2023 ; 481 ( 6 ): 1221 – 1223 . 10.1097/CORR.0000000000002511 36512761
    1. No authors listed . Improving Understanding: The National Hip Fracture Database report on 2021 . National Hip Fracture Database (NHFD) . 2021 . https://www.nhfd.co.uk/FFFAP/Reports.nsf/0/EA5D572779948D14802588D8005C1... ( date last accessed 15 June 2023 ).