Femoral neck fractures: admissions, bed use, outcome and projections

A number of epidemiological studies have shown that the incidence of femoral neck fractures in industrialized countries increases at an exponential rate with age and that age-adjusted incidence rates are approximately twice as high in women than in men. Femoral neck fractures often have serious consequences for the aged, including permanently limiting their mobility, which results in increased dependence on others and hence an increased probability of being admitted to an institution. In this study, hospital inpatient statistics for New South Wales were examined to elucidate age-related trends in admissions to hospital for acute care, length of stay, bed use and outcome of this condition. Projections of the number of persons expected to suffer from femoral neck fractures, the associated number of bed-days that are required and the expected cost of hospital care to the year 2011 have been made. It seems probable that hospital services will not be provided at the necessary rate to cater for the expected increase in bed use from femoral neck fractures and other age-related conditions. Therefore, rational planning of scarce hospital resources will be required. Reductions in acute care hospital bed use for patients with femoral neck fractures could be made by reducing the number of technical failures in surgical treatment, providing more intensive nursing care to reduce postoperative and bed-rest complications, and by providing integrated slow-stream beds for the physical and social rehabilitation of patients.