Context-Understanding the incidence and subsequent mortality following hip fracture is essential to measuring population health and the value of improvements in health care.Objective-To examine trends in hip fracture incidence and resulting mortality over 20 years in the US Medicare population. Main Outcome Measures-Age-and sex-specific incidence of hip fracture and age-and riskadjusted mortality rates. ©2009 American Medical Association. All rights reserved.Corresponding Author: Carmen A. Brauer, MD, MSc, FRCSC, Division of Orthopedic Surgery, University of Calgary, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, AB, Canada T3B 6A8 (carmen.brauer@albertahealthservices.ca). Financial Disclosures: None reported.Disclaimer: This research was performed at the National Bureau of Economic Research, Cambridge, Massachusetts.Additional Information: eTables 1 through 3 are available at http://www.jama.com.
Additional Contributions:We thank Douglas M. Norton, BA, a research assistant at the National Bureau of Economic Research, for help with the initial data analysis. He received no compensation for his help.Author Contributions: Dr Brauer had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Role of the Sponsor:The supporters had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. Conclusion-In the United States, hip fracture rates and subsequent mortality among persons 65 years and older are declining, and comorbidities among patients with hip fractures have increased.
HHS Public AccessThe Number of Hip Fractures occurring in the United States and the resulting postsurgical outcome are a major public health concern. About 30% of people with a hip fracture will die in the following year, 1-3 and many more will experience significant functional loss. [4][5][6][7] The long-term consequences may be great as well. Some studies have shown excess long-term mortality even 10 years after an episode, [8][9][10][11][12] although other studies have only shown moderate increases in mortality. [13][14][15][16][17] Treating hip fractures is also very expensive. A typical patient with a hip fracture spends US $40 000 in the first year following hip fracture for direct medical costs and almost $5000 in subsequent years. 1,[18][19][20] Despite recent literature indicating that the hip fracture incidence may be stabilizing or decreasing, 21-29 concern still exists that because of the aging of the population, the hip fracture incidence will increase worldwide unless additional steps are taken. 7,19,20,22,[30][31][32][33][34][35] Understanding the incidence and postsurgical outcome of hip fractures is a vital first step in improving population health. Our primary objective was to assess trends in the age-and sexspecific incidence and subsequent age-and risk-adjusted mortality of hip fractures among elderly indivi...