Osteoporotic hip fracture costs in the elderly Turkish population

This study was designed to determine the length of hospital stay and treatment costs of patients with osteoporotic hip fractures in Turkey.

A total of 1,118 osteoporotic hip fractures taken from patient records in 35 hospitals connected to a Disease Related Group (DRG) network were included in the study. Inclusion criteria were patients over the age of fifty with a diagnosis of a single, low-energy fracture located at the neck, head, or intertrochanteric region of the femur treated with total/hemi-arthroplasty, screw or nail methods. We examined the demographics, location of fracture, treatment type, length of hospital stay (LOS), direct cost and cost extrapolation based on the numbers of hospitals, beds and patient by hospital.

Of the 1,118 patients (mean age: 75.3 ± 9.9 years), 62.8% were female. The main fracture type was of the femur neck without precise localization. The average LOS was 11.0 ± 7.9 days. The total weighed cost of all 1,118 hip fractures was $2,249,885 per year, indicating an average direct medical cost of $3,119 per patient in the 35 DRG hospitals. Based on this sample, the estimated total number of patients is 15,602 by number of hospitals; 8,521 by number of hospital beds and 9,365 by number of hospitalization, costing $31,530 million; $14,793 million and $18,948 million, respectively.

Diverse results in cost estimations of osteoporotic hip fractures reflect the incoherence of data as well as a lack of standardization of health care services. Therefore, ICD and DRG coding needs to be improved and a national database must be created at least for the invoices of importation of prostheses to fully be able to calculate the burden of osteoporosis across Turkey.