Estimating Hip Fracture Morbidity, Mortality and Costs

Authors

  • R. Scott Braithwaite MD,

    1. Section of Decision Sciences and Clinical Systems Modeling,
      Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;
    Search for more papers by this author
  • Nananda F. Col MD, MPP, MPH, FACP,

    1. Decision
      Systems Group, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; and
    Search for more papers by this author
  • John B. Wong MD, FACP

    1. Division of Clinical Decision Making, Informatics, and Telemedicine, Department of Medicine, Tupper Research Institute, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
    Search for more papers by this author

Address correspondence to R. Scott Braithwaite, MD, University of Pittsburgh Medical Center Montefiore, 583-NE, 200 Lothrop Street, Pittsburgh, PA 15213. E-mail: Braithwaiters@msx.upmc.edu

Abstract

OBJECTIVES:  To estimate lifetime morbidity, mortality, and costs from hip fracture incorporating the effect of deficits in activities of daily living.

DESIGN:   Markov computer cohort simulation considering short- and long-term outcomes attributable to hip fractures. Data estimates were based on published literature, and costs were based primarily on Medicare reimbursement rates.

SETTING:   Postacute hospital facility.

PARTICIPANTS:   Eighty-year-old community dwellers with hip fractures.

MEASUREMENTS:   Life expectancy, nursing facility days, and costs.

RESULTS:   Hip fracture reduced life expectancy by 1.8 years or 25% compared with an age- and sex-matched general population. About 17% of remaining life was spent in a nursing facility. The lifetime attributable cost of hip fracture was $81,300, of which nearly half (44%) related to nursing facility expenses. The development of deficits in ADLs after hip fracture resulted in substantial morbidity, mortality, and costs.

CONCLUSION:   Hip fractures result in significant mortality, morbidity, and costs. The estimated lifetime cost for all hip fractures in the United States in 1997 likely exceeded $20 billion. These results emphasize the importance of current and future interventions to decrease the incidence of hip fracture.

Ancillary