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Economic impact of periprosthetic hip fractures
D González-Martín1, J L Pais-Brito1, S González-Casamayor2
1Orthopedic Surgery and Traumatology Service, Hospital Universitario de Canarias, Tenerife, Spain; Universidad de La Laguna, Tenerife, Spain.
Insights
Periprosthetic hip fractures (PPHF) are costly, averaging €14,610.90 per patient. Revision surgery, extended hospital stays, and multiple operations significantly increase costs, highlighting the need for optimized management protocols.
Area of Science:
- Orthopaedic Surgery
- Health Economics
- Trauma Surgery
Background:
- Hip replacement is a common and successful orthopaedic procedure.
- Periprosthetic hip fractures (PPHF) pose significant patient risks and economic burdens.
- This study provides the first detailed cost analysis of PPHF in a Spanish tertiary hospital.
Purpose of the Study:
- To conduct a comprehensive cost analysis of Periprosthetic Hip Fractures (PPHF).
- To identify the primary cost drivers associated with PPHF management.
- To inform the development of cost-effective treatment strategies for PPHF.
Main Methods:
- Retrospective analysis of patients diagnosed with PPHF between 2009 and 2019.
- Inclusion of all relevant costs: hospital stay, operating theatre, implants, analyses, consultations, rehabilitation, radiology, microbiology, and blood transfusions.
- Categorization of surgical treatments into open reduction and internal fixation (ORIF) and revision surgery.
Main Results:
- 78 patients (49 female, 29 male, mean age 78.74) were analyzed.
- Total cost amounted to €1,139,650.17, with an average cost of €14,610.90 per patient.
- Revision surgery, admissions >30 days, and multiple operations significantly increased costs. Key cost factors: hospital stay (46%), surgery (35%), and implants (24%).
Conclusions:
- Revision arthroplasty and ORIF treatments, prolonged hospital stays (>30 days), and multiple surgical interventions are significant cost drivers for PPHF.
- The average hospital cost for PPHF is €14,610.90.
- Establishing optimized perioperative management protocols is crucial for reducing PPHF morbidity and associated healthcare costs.
Introduction:
Hip replacement is one of the most successful operations in orthopaedic surgery. Periprosthetic hip fractures (PPHF) have very serious consequences for the patient, and they also entail a very important economic impact on healthcare systems. The aim of the study was to provide the first detailed cost analysis of PPHF in a traumatology and orthopaedics service in a third level hospital in Spain.
Methods:
The study included all patients admitted between 2009 and 2019 with a diagnosis of "PPHF". We assessed hospital stay cost, total cost of the operating theatre, cost of the implants used, analyses, consultations with other specialists, rehabilitation sessions, radiological tests, microbiology, blood transfusions and other surgical operations during the same admission.
Results:
78 patients were included in the study, 49 women and 29 men, with a mean age of 78.74 years (R 45-92). 69 patients received surgical treatment, 75% had open reduction and internal fixation (ORIF), and 25% had revision surgery. The total cost was €1,139,650.17. The average cost was €14,610.90. Significantly higher costs were incurred for revision compared to ORIF treatments, admissions that lasted more than 30 days, and patients who required more than one operation during admission. The most costly factors were the hospital stay (46%), the cost of the surgery itself (35%), and the implants (24%).
Conclusions:
Revision arthroplasty versus ORIF treatment, admissions lasting more than 30 days, and patients requiring more than one operation on admission incurred significantly higher costs. The average cost, from a hospital perspective, generated by a PPHF was €14,610.90. The most costly factors were, in descending order, the hospital stay, the cost of the surgery itself, and the implants. It is necessary to establish protocols and updated therapeutic algorithms in the perioperative management of PPHF in order to reduce both morbidity rates and associated costs.
