Hospitalizations for hip fractures among elderly persons in Hawaii, 1986-1990

Hawaii differs ethnically, geographically, and culturally from other states; therefore, United States hip fracture data cannot be assumed to apply to Hawaii. The purpose of this research was to gain new knowledge about hip fracture in Hawaii to plan and target appropriate services and design preventive measures. Peer Review Organization Medicare data were analyzed for persons age 65+ over a 4-year period. Average length of hospital stay was 20 days resulting in an average estimated charge per hospitalization of $20,000. Of those with E-Codes, 94% sustained falls. Fifty-five percent had one or more complicating illness. Unexpected significant differences were found among the islands: the average annual hospitalization incidence rate/1,000 on Kauai (8.4) was almost twice that of the Island of Hawaii (4.4), and Maui (3.9), and significantly greater than Oahu (5.4), primarily in women over 85. The island differences raise important questions in need of investigation, and suggest target populations and locations for prevention.