Impact of hip fracture on hospital care costs: a population-based study. Issue 2 (February 2016)

• Record Type: Journal Article
• Authors: Leal, J.; Gray, A.; Prieto-Alhambra, D.; Arden, N.; Cooper, C.; Javaid, M.; Judge, A.
• Is Part Of: Osteoporosis international. Volume 27:Issue 2(2016)
• Page Start: 549
• Page End: 558
• Publication Date: 2016-02
• Subjects: Burden -- Cost -- Epidemiology -- Health economics -- Hip fracture -- Osteoporosis; Osteoporosis -- Periodicals; Bones -- Metabolism -- Disorders -- Periodicals; 616.716005
• DOI: 10.1007/s00198-015-3277-9
• Languages: English
• ISSNs: 0937-941X

Abstract

Abstract Summary 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.