Epidemiology of hip fractures

Rapp, Kilian; Büchele, Gisela; Dreinhöfer, Karsten; Bücking, Benjamin; Becker, Clemens; Benzinger, Petra

doi:10.1007/s00391-018-1382-z

Cited by 140 publications

(68 citation statements)

References 66 publications

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“…There is a substantial variation in hip fracture incidence between countries in Europe and around the world; a seven-fold difference has been found in Europe, with the highest incidence rate in Scandinavia and the lowest in southern countries (2)(3)(4). Recent publications observed changes in the secular trends, many of them reporting decreases or leveling-off; reports on increasing rates are a few (5,6).…”

Section: Introductionmentioning

confidence: 99%

Incidence and Time Trend of Hip Fractures in Romania: a Nationwide Study From 2008 to 2018

et al. 2019

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Background. Hip fractures are a major issue of public health as they are responsible for high morbidity, excess mortality and costs. There are differences in Europe and worldwide in the incidence rates of hip fractures and time trends, in the context of the population aging. Ten years ago, we characterized the incidence of hip fracture in Romania using data from the national hospital discharge register. Objective. This is the first Romanian study to assess the hip fracture incidence rates over a period of 11 years, between 2008 and 2018. Subjects and Methods. This analysis is a nationwide retrospective study on hospitals reporting primary DRG data on hip fracture, using a rigorous definition with both diagnostic and surgical procedure codes. The population aged 40+ was stratified in 5-year intervals and both the crude incidence rates and the adjusted incidence rates of hip fracture using standardization on age for the 2018 reference population were calculated in women and men. Results. From 2008 to 2018, the number of hip fractures rose by 53 % in women (from 7513 to 11512) and 22.4 % in men (from 4266 to 5220). Meanwhile, the Romanian population over 40 years increased by 12.5% in women and 14.2% in men. The crude incidence rate rose by 36.2% in women and 7.2% in men and the age-standardized incidence rates by 27.4% in women and 6% in men. These increases are mostly based on 85+ age populations' changes. Conclusions. In Romania, the hip fractures incidence continues to grow throughout an 11-year-period, especially in women, representing an increasing burden for our society.

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Section: Introductionmentioning

confidence: 99%

Incidence and Time Trend of Hip Fractures in Romania: a Nationwide Study From 2008 to 2018

et al. 2019

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“…Hip fracture is a leading cause of death and disability among the elderly worldwide. 1,2 The incidence is rising as populations age, and there are now over 1.6 million hip fractures globally each year. 1 In the United Kingdom alone, there are 70 000 cases annually at a cost of £2 billion.…”

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confidence: 99%

Pay for performance and hip fracture outcomes

Metcalfe

Zogg

Judge

et al. 2019

The Bone & Joint Journal

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Aims Hip fractures are associated with high morbidity, mortality, and costs. One strategy for improving outcomes is to incentivize hospitals to provide better quality of care. We aimed to determine whether a pay-for-performance initiative affected hip fracture outcomes in England by using Scotland, which did not participate in the scheme, as a control. Materials and Methods We undertook an interrupted time series study with data from all patients aged more than 60 years with a hip fracture in England (2000 to 2018) using the Hospital Episode Statistics Admitted Patient Care (HES APC) data set linked to national death registrations. Difference-in-differences (DID) analysis incorporating equivalent data from the Scottish Morbidity Record was used to control for secular trends. The outcomes were 30-day and 365-day mortality, 30-day re-admission, time to operation, and acute length of stay. Results There were 1 037 860 patients with a hip fracture in England and 116 594 in Scotland. Both 30-day (DID -1.7%; 95% confidence interval (CI) -2.0 to -1.2) and 365-day (-1.9%; 95% CI -2.5 to -1.3) mortality fell in England post-intervention when compared with outcomes in Scotland. There were 7600 fewer deaths between 2010 and 2016 that could be attributed to interventions driven by pay-for-performance. A pre-existing annual trend towards increased 30-day re-admissions in England was halted post-intervention. Significant reductions were observed in the time to operation and length of stay. Conclusion This study provides evidence that a pay-for-performance programme improved the outcomes after a hip fracture in England. Cite this article: Bone Joint J 2019;101-B:1015–1023.

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“…e countries with the highest incidence are those in Northern Europe (Norway, Sweden, Iceland, and Ireland), followed by those in Central Europe, (Denmark, Belgium, Germany, Switzerland, and Austria), those in Eastern Europe (Czech Republic, Slovakia, and Hungary), and those in the Middle East (Iran and Oman). Other countries with high incidence rates of hip fracture are Argentina and Taiwan [33].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and Direct Medical Cost of Osteoporotic Hip Fracture in Chile

Quevedo

Ormeño

Weissglas

et al. 2020

Journal of Osteoporosis

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The osteoporotic hip fracture is associated with a high impact on morbidity, mortality, and health expenditure. The Chilean health system is made up of a mixed care system, with the public system called FONASA and the private system called ISAPRE. The people with lower incomes are listed on FONASA and correspond to 80.8% of the population. The aims of this study were to describe the incidence of hip fracture in the Chilean population from the age of 45 years and to estimate the direct medical cost of this disease. The records of the Department of the Health Statistics and Information of the Ministry of Health were used, from which the number of national hospital discharges due to hip fractures was obtained (codes S720, S721, and S722 of the ICD-10), in adults aged 45 years or older, by sex, from 2006 to 2017. The cost of osteoporotic hip fracture treatment in the public health system was obtained from the data of the surgical treatment according to the payment method associated with diagnosis (PAD bonus). A surgical intervention budget was used in a private clinic to calculate the direct cost of osteoporotic hip fracture in the private system. Between 2006 and 2017, the number of hospital discharges due to osteoporotic hip fracture in adults aged 45 years and older has increased progressively, registering 9.583 hospital discharges for this cause in 2017, which corresponds to 50% more than those recorded in 2006, with a 3 : 1 F/M ratio. The mean annual rate of hip fractures is 148.7 per 100,000 inhabitants aged above 45 years. The individual cost of managing an osteoporotic hip fracture in the public system was USD$ 3,919, and USD$ 9,092 in the private health system. The incidence of hip fracture was comparable with data from Southern European countries and from neighboring countries, such as Argentina and Uruguay. Hospitalization cost of hip fracture in Chile was 34 million USD per year. Hip fracture constitutes a serious healthcare problem in Chile, and efforts for the prevention and management of osteoporosis are needed.

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Epidemiology of hip fractures

Cited by 140 publications

References 66 publications

Incidence and Time Trend of Hip Fractures in Romania: a Nationwide Study From 2008 to 2018

Incidence and Time Trend of Hip Fractures in Romania: a Nationwide Study From 2008 to 2018

Pay for performance and hip fracture outcomes

Epidemiology and Direct Medical Cost of Osteoporotic Hip Fracture in Chile

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