Costs of fragility hip fractures globally: a systematic review and meta-regression analysis

Abstract

Purpose This study was conducted in order to systematically review the costs of hip fractures globally and identify drivers of differences in costs. Methods A systematic review was conducted to identify studies reporting patient level fragility hip fracture costs between 1990 and 2015. We extracted data on the participants and costs from these studies. Cost data concerning the index hospitalisation were pooled, and a meta-regression was used to examine its potential drivers. We also pooled data on the first-year costs following hip fracture and considered healthcare, social care as well as other cost categories if reported by studies. Results One hundred and thirteen studies reported costs of hip fracture based on patient level data. Patients developing complications as well as patients enrolled in intervention arms of comparative studies were found to have significantly higher costs compared to the controls. The pooled estimate of the cost for the index hospitalisation was $10,075. Health and social care costs at 12 months were $43,669 with inpatient costs being their major driver. Meta-regression analysis identified age, gender and geographic region as being significantly associated with the differences in costs for the index hospitalisation. Conclusion Hip fracture poses a significant economic burden and variation exists in their costs across different regions. We found that there was a considerable variation across studies in terms of study design, methodology, follow-up period, costs considered and results reported that highlights the need for more standardisation in this area of research.

Hypoglycaemia is associated with increased risk of fractures in patients with type 2 diabetes mellitus: a cohort study

“…Each year in the United Kingdom, 1.8 million fractures occur with an annual incidence of about 3.6% and a lifetime prevalence of approximately 40% (1,2,3). The annual cost in the United Kingdom for hip fractures alone including medical and social care is about £2 billion (4).…”

Epidemiology and Direct Medical Cost of Osteoporotic Hip Fracture in Chile

“…e annual expenditure associated with osteoporotic fractures and osteoporosis is estimated to be greater than that identified in this study (USD 34 million), as the expenditure identified in this study only quantifies the expenditure associated with the management of the osteoporotic hip fracture and not the expenditure on the annual monitoring of fracture, in other fracture types, in tests used for the diagnosis of osteoporosis, or in the treatment of osteoporosis. e costs of medical treatment during the year following the surgery in the US vary in a range from $21,559 to $44,200, which is influenced by the local health policy that influences the effectiveness of the handling of this pathology [10]. Within the limitations of the work, it can be mentioned that the complications of prolonged rest or surgical procedures and infection of the operative pathway, venous thrombosis, or pulmonary thromboembolism among others were not considered in the evaluation of the direct economic impact of hip fractures.…”

“…e cost of the initial hospitalization in the treatment of osteoporotic hip fractures in the public system of Chile is similar to that of Latin American countries such as Uruguay and Argentina (3-4 thousand dollars) [19], while the cost in the private health system is similar to that of European countries such as Belgium (9 thousand dollars) [27], being very close to the world average (10 thousand dollars) [10].…”

“…A systematic review of 113 studies from 1993 to 2015, which included more than 670,000 patients, reported that the approximate cost of the first year after suffering a hip fracture is $43,000 dollars, with the approximate cost of hospitalization being $10,000 dollars [10]. In 2010, the cost associated with osteoporosis in Europe was estimated to be 37 billion euros, representing 66% of the cost associated with fracture management and 29% of the cost of postfracture care [5,11].…”

Non-setting, injectable biomaterials containing particulate hydroxyapatite can increase primary stability of bone screws in cancellous bone

“…Hip fracture is by far the most common reason for hospital admission, it may occurs either as a result of a fragility fracture (Acevedo et al, 2018) or a fall. Most hip fracture patients receive operative treatment (Weycker et al, 2016;Williamson et al, 2017). The ability of the proximal femur to bear the internal load actions resulting from a fall is significantly reduced by osteoporosis and in particular, it has been demonstrated that this is related to reduced areal bone mineral density (Curtis et al, 2016).…”