Cost of hospitalisation for hip fracture—findings from the Irish hip fracture database

Abstract

Summary The authors utilised the Irish Hip Fracture Database (IHFD) to quantify the impact of hip fracture on the health service in terms of incidence, bed days and financial costs. The absolute number of hip fracture cases recorded by the IHFD has increased, as has the associated costs of hospitalisation. Introduction Hip fracture places a considerable clinical and financial burden on the healthcare system, with acute hospitalisation accounting for a substantial proportion of the costs incurred. This paper aimed to quantify the cost of hospitalisation for hip fracture in Ireland in terms of bed days and direct hospital costs. Methods The authors analysed 23,494 cases in the Irish Hip Fracture Database (IHFD) from 2014 to 2020. Case numbers and length of stay were analysed annually. Hospital costs for hip fracture were described using the 2020 Activity-Based Funding Price List, which outlines the fees paid to public hospitals for inpatient activity. Results For the time period 2014–2020, the total cost of hospitalisation for hip fracture was approximately €296 million, equating to approximately €11,700 per episode of care. The annual cost of hospitalisation increased from approximately €34 million in 2014 to €44 million in 2020. In 2020, the mean length of stay for hip fracture was 17 days accounting for > 62,600 acute hospital bed days. Conclusion The absolute number of hip fracture cases recorded by the IHFD has increased, as has the cost of hospitalisation. Given the current capacity issues and economic constraints, there is a growing need to prioritise time spent in the most expensive acute hospital setting to the immediate perioperative period and maximise the use of community services and early supportive discharge for the rehabilitation phase. Supplementary Information The online version contains supplementary material available at 10.1007/s00198-021-06294-7.

A nationwide analysis on the interaction between frailty and beta-blocker therapy in hip fracture patients

“…Hip fracture patients comprise a significant challenge for health care systems globally. Owing to the high degree of frailty and considerable comorbidity burden in this population, they demand a substantial amount of resources both during their hospital stay and post discharge [1][2][3]. In 2010, an estimated 2.7 million people suffered a hip fracture, accounting for approximately 20% of all osteoporotic fractures in those who were 50 years or older [4][5][6].…”

The incidence, prevalence, and health burden of hip fractures in China: Data from the global burden of disease study 2019

“…In China, the average cost of treating a hip fracture reached ¥53 440, which is almost the total annual income of many Chinese families. In Iran, another developing country in Asia, the cost for treating each hip fracture was approximately €11,700, and the total hospitalization cost has been increasing with year ( Ferris et al, 2022 ), placing a huge burden on both the patient’s family and the society.…”

“…In 2019, the global incidence of hip fracture is estimated to be over 14 million, with the disease burden estimated to be 2.9 million years lived with disability (YLD) ( Dong et al, 2022b ). As the global population continues to increase and age, the health burden associated with hip fractures is expected to increase in the future, posing a major socioeconomic and healthcare challenge worldwide ( Ferris et al, 2022 , Hou et al, 2022 , Kwak et al, 2022 , Mafirakureva et al, 2023 ).…”

Development of a Frailty Index in the Irish Hip Fracture Database

“…Raising awareness of this fact amongst non-specialist clinicians could help trigger interventions (such as proactive identification and management) to minimise the severity and duration of delirium, which is known to prolong hospital LOS and lead to adverse patient outcomes including new institutionalisation and mortality [ 48 , 49 ]. Easy-to-use risk identification strategies that can be proactively implemented by non-specialists are important because, with a mean LOS of 17 days for Irish hip fracture patients [ 22 ], there is a growing need to prioritise time spent in the acute hospital setting, where possible, to the immediate perioperative period and maximise the use of early supported discharge options and community-based services for the rehabilitation phase [ 50 ].…”