Mortality Following Hip Fracture Before and After Implementation of the Prospective Payment System

Ray, Wayne A.; Griffin, Marie R.; Baugh, David K.

doi:10.1001/archinte.1990.00390210085019

Cited by 45 publications

(9 citation statements)

References 24 publications

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“…In patients over age 74 years this percentage was even higher. Mortality rate after hip fracture has been reported to be around 20% within 1 year [32] and seems to be higher in men than in women [33].…”

Section: Discussionmentioning

confidence: 99%

Incidence and Direct Medical Costs of Hospitalizations due to Osteoporotic Fractures in Switzerland

et al. 1997

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The objective of this study was to estimate the annual direct medical costs of hospitalizations due to osteoporotic fractures in Switzerland. Days of hospital stay in 1992 were quantified using the casuistic of the medical statistics department of VESKA (Vereinigung Schweizerischer Krankenhäuser, the Swiss Hospital Association), which covers 43% of all hospital beds of that country. Number and incidence of total hospitalizations due to fractures were calculated by extrapolating to 100% the 43% VESKA-selected sample. To estimate number and incidence of hospitalizations due to osteoporotic fractures, internationally accepted age-specific osteoporosis attribution rates were applied. According to the latter the probability of a fracture being caused by osteoporosis increases with age. Mean length of stay for all fractures was calculated (= total hospital days divided by number of cases). By multiplying these mean lengths of stay by the number of osteoporosis-related fracture cases, the number of bed-days due to osteoporotic fractures was calculated. To compare the direct medical costs of hospitalization due to osteoporosis with those due to other frequent diseases, days of hospital stay caused by chronic obstructive pulmonary disease (COPD), stroke, acute myocardial infarction and breast cancer were estimated using the same methodology. A total estimate of 63,170 (f: 33,596, m: 29,574) hospitalizations due to fractures (and other osteoporosis-related diagnoses) was calculated, thus leading to overall annual incidence rates of hospitalizations for fractures of 950/100,000 women and 877/100,000 men. In women, 548,615 hospital days were found to be caused by osteoporosis, 353,654 days by COPD, 352,062 days by stroke, 200,669 days by breast carcinoma and 131,331 days by myocardial infarction. In men, COPD caused more hospitalization days (537,164) than myocardial infarction (196,793), stroke (180,524) or osteoporosis (152,857). Taking a mean price for a hospital day in Switzerland of 845 Swiss francs, the annual costs of acute hospitalizations due to osteoporosis and its complications were approximately 600 million Swiss francs (f: 464, m: 130 million Swiss francs) in 1992. We conclude that there is enough economic evidence to justify wide-scale interventions against osteoporosis in Switzerland.

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Section: Discussionmentioning

confidence: 99%

Incidence and Direct Medical Costs of Hospitalizations due to Osteoporotic Fractures in Switzerland

et al. 1997

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“…On one hand, hip fracture increases the morbidity and mortality in the elderly [2][3][4]; on the other hand, it is a substantial source of health care expenditure [5,6]. 18-33% of older hip fracture patients die within one year following their fracture [7][8][9][10][11][12][13][14][15], 15-25% require longterm nursing home care or institutionalization [16], and approximately 50% can neither walk independently nor achieve their previous level of independent living [8,[16][17][18]. The incidence of hip fracture appears to be increasing all over the world [19].…”

Section: Introductionmentioning

confidence: 99%

Study of sex differences in the association between hip fracture risk and body parameters by DXA-based biomechanical modeling

Nasiri

Luo

2016

Bone

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“…However, generalization of these data to the Canadian context is problematic due to differences in population risk levels, health care systems and treatment patterns. For example, in the United States, patients are commonly admitted to a LTC facility for rehabilitation and subsequently discharged [19], while in Australia rehabilitation occurs mainly in the acute care setting [20]. Although in Canada preliminary rehabilitation occurs during initial hospitalization, patients are often transferred to rehabilitation and chronic care facilities [7,21].…”

Section: Introductionmentioning

confidence: 99%

Economic Implications of Hip Fracture: Health Service Use, Institutional Care and Cost in Canada

et al. 2001

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As the burden of illness associated with hip fracture extends beyond the initial hospitalization, a longitudinal 1 year cohort study was used to analyze levels of health service use, institutional care and their associated costs, and to examine patient and residency factors contributing to overall 1 year cost. Patients in the study were aged 50 year and over, and had been admitted to an acute care facility for hip fracture in the Hamilton-Wentworth region of Canada from 1 April 1995 to 31 March 1996. Health care resources assessed included initial hospitalization, rehospitalization, rehabilitation, chronic care, home care, long-term care (LTC) and informal care. Regression analysis was used to determine the effects of age, gender, residence, survival and days of follow-up on 1 year cost. The mean 1 year cost of hip fracture for the 504 study patients was 26,527 Canadian dollars (95% Cl: $24,564-$28,490). One year costs were significantly different for patients who returned to the community ($21,385), versus those who were transferred to ($44,156), or readmitted to LTC facilities ($33,729) (p < 0.001). Initial hospitalization represented 58% of 1 year cost for community-dwelling patients, compared with 27% for LTC residents. Only 59.4% of community-dwelling patients resided in the community 1 year following hip fracture, and 5.6% of patients who survived their first fracture experienced a subsequent hip fracture. Linear regression indicated place of residence, age and survival were all important contributors to 1 year cost (p < 0.001). While the average 1 year cost of care was $26,527, the overall cost varied depending on a patient's place of residence, age, and survival to 1 year. Annual economic implications of hip fracture in Canada are $650 million and are expected to rise to $2.4 billion by 2041.

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Mortality Following Hip Fracture Before and After Implementation of the Prospective Payment System

Cited by 45 publications

References 24 publications

Incidence and Direct Medical Costs of Hospitalizations due to Osteoporotic Fractures in Switzerland

Incidence and Direct Medical Costs of Hospitalizations due to Osteoporotic Fractures in Switzerland

Study of sex differences in the association between hip fracture risk and body parameters by DXA-based biomechanical modeling

Economic Implications of Hip Fracture: Health Service Use, Institutional Care and Cost in Canada

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