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Estimating hip fracture morbidity, mortality and costs
R Scott Braithwaite1, Nananda F Col, John B Wong
1Section of Decision Sciences and Clinical Systems Modeling, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, PA 15213, USA. Braithwaiters@msx.upmc.edu
Journal of the American Geriatrics Society
|February 18, 2003
Summary
Hip fractures significantly reduce life expectancy and increase nursing facility stays. The lifetime cost of hip fracture is substantial, highlighting the need for preventative measures.
Area of Science:
- Gerontology
- Public Health
- Health Economics
Background:
- Hip fractures are a major cause of morbidity and mortality in the elderly.
- Fracture-related deficits in activities of daily living (ADLs) exacerbate negative outcomes.
Purpose of the Study:
- To estimate the lifetime impact of hip fractures on morbidity, mortality, and healthcare costs.
- To incorporate the influence of ADL deficits into these estimations.
Main Methods:
- A Markov computer cohort simulation model was employed.
- Data were sourced from published literature and Medicare reimbursement rates.
- The study focused on 80-year-old community dwellers experiencing hip fractures.
Main Results:
- Hip fracture reduced life expectancy by 1.8 years (25%) and led to 17% of remaining life spent in nursing facilities.
- The estimated lifetime cost per hip fracture was $81,300, with nursing facility expenses accounting for 44%.
- ADL deficits significantly increased morbidity, mortality, and costs post-fracture.
Conclusions:
- Hip fractures impose considerable lifetime burdens in terms of mortality, morbidity, and economic costs.
- The total estimated cost for hip fractures in the US in 1997 exceeded $20 billion.
- Interventions to reduce hip fracture incidence are crucial for public health and economic reasons.