The Financial Burden of Delayed Hip Fracture Surgery: A Single-Center Experience

Abstract

Fragility hip fractures have become a worldwide epidemic with serious socioeconomic implications. The projected number of hip fractures by 2050 is estimated to reach 4.5 million cases. The aim of this study was to calculate the in-hospital financial burden on public health insurance funds related to the delayed treatment of hip fractures. This research took place in a tertiary university hospital that is a major trauma center in Thessaloniki, which is second largest city in Greece . A retrospective search was conducted in the electronic hospital database for patients older than 65 years, with low energy hip fractures that were surgically treated between November 18, 2018, and October 20, 2019. Age, length of stay (LOS), days to surgery, postoperative LOS, anticoagulation medication, major and minor complications, and the reimbursement that the hospital received from public health insurance funds were recorded. Cost deviation from the standard tariff for the treatment of these fractures was also calculated. Of a total of 145 patients, 32.4% had early surgery as opposed to 67.6% who were operated after 48 hours from admission. The excess financial burden from the baseline reimbursement for those operated within 48 hours from admission was 4,074.64€, while for the group that received delayed surgery it was 45,654.14€. Patients under any form of anticoagulation therapy were seven times more probable to have delayed surgery [OR=6.8; 95% confidence interval (CI): 2.97-18.18; p<0.01] and were 3.5 times more probable to have minor complications (OR: 3.6; 95% CI: 1.19-11.23; p<0.017). Early surgery is beneficial to the patient and reduces the economic burden on healthcare public funds. Every effort should be made to manage these patients in a timely manner.

Risk factors for perioperative acute heart failure in older hip fracture patients and establishment of a nomogram predictive model

“…The harmful effects of perioperative heart failure make it an important problem in the healthcare system. Previous studies showed that perioperative acute heart failure (AHF) substantially increased mortality within 30 days after surgery to 65%, prolonged the average length of stay of patients by 4 days, and increased the average hospitalization cost by about 5500 euros [ 7 – 10 ].…”

A Demographic Survey of Pertrochanteric Fractures Based on the Revised Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association (AO/OTA) Classification Using 3D CT Scan Images

“…A demographic survey of femoral pertrochanteric fractures provides several important information for the healthcare system of a country. First, pertrochanteric fractures rank as one of the most common surgically treated injuries in the elderly population, considering that the incidence of hip fractures is projected to reach six million globally by 2050 [ 1 ]. Second, the poor functional prognosis related to pertrochanteric fractures has been a burden on society, where 20%-30% of patients die within a year postoperatively and 50%-60% suffer from disability.…”

Inter-observer Agreement and Reproducibility of Pertrochanteric Fracture Classification Using Plain Radiograph Versus Computed Tomogram Images: A Study of 523 Patients

“…The incidence of femoral pertrochanteric fractures among elderly patients is steadily rising on a global scale [1]. Consequently, it becomes imperative for surgeons to bestow due diligence upon the application of a precise preoperative imaging classification system, as it profoundly impacts postoperative outcomes.…”