Cost of osteoporotic hip fracture in Spain per Autonomous Region

Bartra, Agustí; Caeiro, J.R.; Mesa-Ramos, Manuel; Etxebarría-Foronda, I.; Montejo, Jorge; Carpintero, Pedro; Sorio-Vilela, F.; Gatell, S.; Canals, Laura; Proa, en representación de los investigadores del estudio

doi:10.1016/j.recote.2018.11.004

Cited by 11 publications

(11 citation statements)

References 19 publications

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“…In our country the direct costs of hip fractures are between 6,500 and 12,300 euros [31] during the rst year, according to the Autonomous Community Government. In terms of hospital stay, our region is one of the communities with the highest costs related to it, reaching a value of close to 6,500 euros per patient.…”

Section: Discussionmentioning

confidence: 94%

“…In terms of hospital stay, our region is one of the communities with the highest costs related to it, reaching a value of close to 6,500 euros per patient. Certain neighbouring countries have highly variable direct costs in relation to hip fracture, and we have found important differences between, for instance, Poland with 1,256 euros, France with 9,996 euros, United Kingdom with 15,300 pounds or Switzerland with 29,910 euros [28,31].…”

Section: Discussionmentioning

confidence: 99%

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Influence of Orthogeriatrics on the Morbidity and Mortality of Patients with Hip Fracture.

Balvís-Balvís¹,

Domínguez-Prado²,

Ferradas-Garcia³

et al. 2020

Preprint

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BACKGROUND: Osteoporotic hip fractures often occur in fragile, elderly patients and are associated with a significant morbidity and mortality. The objective of this study is to evaluate the morbidity and mortality together with the length of hospital stay in patients with hip fracture in two non-consecutive years and to compare their evolution with the involvement of a specialist in orthogeriatric care.MATERIAL AND METHODS: Retrospective study that reviewed a total of 633 patients with an average age of 85.5 years who suffered a hip fracture and were treated in the same service of Trauma and Orthopaedics in two different years (2012 and 2017). We have analysed mortality, morbidity during their hospital stay, the length of hospital stays and the cost-benefit after the implication of a specialist in orthogeriatric care in 2017.RESULTS: Mortality during their hospital stay decreased significantly from 10% in 2012 to 3.6% in 2017. We have also observed a decrease in mortality at 30 days (10.5% versus 7%) and after one year (28.9% versus 24.9%) between both groups, although these differences were not statistically significant. The length of hospital stays decreased significantly between both periods observed. The average stay decreased by 4.8 days, the surgical delay decreased by 1.1 days and the postoperative hospital stay decreased by 3.4 days. The total annual economic savings estimated due to the involvement of a geriatrician in the follow-up of patients with hip fracture was 1,017.084.94€.CONCLUSIONS: The multidisciplinary approach of patients with hip fracture results in a more effective and more efficient care model. The quality of care and the clinical care optimisation of patients in the perioperative period improve and both hospital stay and mortality during hospital stay decrease significantly. A significant economic saving is also obtained in the treatment of this pathology.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Influence of Orthogeriatrics on the Morbidity and Mortality of Patients with Hip Fracture.

Balvís-Balvís¹,

Domínguez-Prado²,

Ferradas-Garcia³

et al. 2020

Preprint

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“…Hip fractures represent a general public health problem due to their high incidence and their impact on mortality and loss of quality of life 1 . In the coming years, with the progressive aging of the population, its incidence is expected to increase, incurring a significant drain on resources 2 . Crude mortality figures after a hip fracture are considered in most studies.…”

Section: Introductionmentioning

confidence: 99%

“…Rev Osteoporos Metab Miner. 2021;13 (2):51-57 ORIGINALS Dementia affected 6.53% of the Spanish population over 60 years of age in 2020 7 . The current prevalence worldwide is more than 40 million patients, which will double every 20 years 8,9 .…”

Section: Introductionmentioning

confidence: 99%

Impacto de la demencia en la supervivencia de los pacientes con fractura de cadera intervenidos mediante prótesis total y parcial

Etxebarría-Foronda

Larrañaga

Ibarrondo

et al. 2021

Rev Osteoporos Metab Miner

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Objetive: To carry out a comparative survival analysis of patients diagnosed with hip fractures (HF) in the Basque Health Service from 2010 to 2016 depending on whether or not they were diagnosed with dementia and the type of arthroplasty. Material and methods:Observational study (real world data) of survival. The data were obtained from the administrative and clinical databases of the Basque Health Service using the Oracle Business Intelligence (OBI) manager. All cases of femur neck fractures from 2010 to 2016 were analyzed in the Basque Health Service. A descriptive analysis was carried out to detect differences between groups according to previous diagnosis of dementia and type of prosthesis. The Kaplan-Meier method was used to obtain the survival curves and their comparison was made in pairs using the Achievement test. The adjusted risk of death for each group was analyzed with the Cox regression model. Results: 5,867 patients with CF were identified, being 1,131 patients without dementia and total prosthesis, 3,073 without dementia and partial prosthesis, 176 with dementia and total prosthesis and 1,487 with dementia and partial prosthesis. The median survival was 9.08 years, 3.79 years, 2.55 years, and 2.54 years respectively. The comparison of the survival curves was significant for all cases except between the last two groups. Using the first group as a reference, the odds ratio of death for the rest was 1.56, 2.27 and 2.37 respectively. When analyzing the risk of death only for patients with dementia, the type of prosthesis was not statistically significant. Conclusions: Dementia influences the survival curve of patients who undergo arthroplasty after a femur neck fracture, with those who undergo a total arthroplasty have a similar mortality rate as those who undergo partial arthroplasty.

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“…In Spain, the average total cost of the first admission for hip fracture is EUR 5096.30. Mean length of hospital stay is 11.8 days, with a daily hospitalization cost of EUR 431.89 [6]. These figures are similar to other countries such as Germany and Ireland, where each patient's hospital stay generates an expense between EUR 7000 to EUR 9000; the United Kingdom, where annual health system expenditure for hip fractures reaches EUR 2.3 billion [5,7]; and the United States, where total costs are estimated at EUR 8.1 billion, with an average daily expenditure of EUR 2804 per admission [1].…”

Section: Introductionmentioning

confidence: 99%

Outcomes evaluation after application of multidisciplinary protocol of shared hospital care in patients aged 65 years and older and operated for hip fracture

Marín

Martínez

Ripoll

et al. 2019

Preprint

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Purpose In geriatric patients, hip fracture is considered the greatest complication of osteoporosis in terms of morbidity, mortality, and cost. The aim of this study is to assess the effects of a multidisciplinary shared care protocol (trauma services, internal medicine, emergencies, anesthesia, nursing, hematology, pharmacy, rehabilitation, home hospitalization unit, and social services) on hospital stay and in-hospital mortality in inpatients aged 65 years or older and operated for hip fracture. Methods Retrospective cohort study between January 2011 and December 2017. The unexposed group was made up of patients who did not receive care according to the multidisciplinary protocol, while the exposed group did. We excluded patients with polytrauma, conservative treatment, bilateral hip fracture, pathological fracture, or previous fracture already included in the series. Variables analyzed were demographic data, medical comorbidities, Charlson index, hemoglobin levels, hematocrit and blood transfusion, antiplatelet drugs, length of surgical delay, length of hospital stay, in-hospital mortality, and a composite risk outcome considering in-hospital mortality and/or hospital stay of more than 10 days. We fit a multivariable logistic regression model to calculate the odds ratio (OR) of experiencing outcomes. Results The cohort included 681 patients: 310 were unexposed and 371, exposed. Compared to the unexposed group, patients receiving protocolized multidisciplinary care showed significantly lower in-hospital mortality (3.5% versus 7.7%; p = 0.015) and were less likely to have a hospital stay of more than 10 (16.4% versus 24.2%; p = 0.012). Mean length of hospital stay was 0.7 fewer days in the exposed group. Multivariable analysis showed the composite risk outcome was 51% lower in the exposed group, after adjusting for age, sex, heart failure, days to surgery, blood transfusion after surgery, and postoperative hemoglobin levels. Conclusion Implementing the multidisciplinary shared care protocol halved the risk of in-hospital mortality and/or a hospital admission of more than 10 days in patients over 65 years with proximal femur fracture. It also reduced mean length of hospital stay.

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Cost of osteoporotic hip fracture in Spain per Autonomous Region

Cited by 11 publications

References 19 publications

Influence of Orthogeriatrics on the Morbidity and Mortality of Patients with Hip Fracture.

Influence of Orthogeriatrics on the Morbidity and Mortality of Patients with Hip Fracture.

Impacto de la demencia en la supervivencia de los pacientes con fractura de cadera intervenidos mediante prótesis total y parcial

Outcomes evaluation after application of multidisciplinary protocol of shared hospital care in patients aged 65 years and older and operated for hip fracture

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