One-year health and care costs after hip fracture for home-dwelling elderly patients in Norway: Results from the Trondheim Hip Fracture Trial

Abstract

Aims: The aim of this study was to estimate the one-year health and care costs connected to a hip fracture for home dwelling patients 70 years and older in Norway, paying specific attention to patient status at the time of the fracture and cost differences due to various patient pathways after the fracture.Methods: Data on health and care service provision were extracted from hospital and municipal records and from national registries, while data on unit costs were collected from the municipality, the hospital administrations, and published studies. Four different patient pathways were identified and total costs for sub-groups of patients according to age, gender, fracture type, and instrumental activity of daily living at fracture incidence were calculated. Descriptive statistics were used to identify cost estimates.Results: The mean total one-year costs per patient were 68,376 EUR, and the costs for patients alive one year after the hip fracture constituted 71,719 EUR. The patients' age and pre-fracture functional status contributed most to the total costs.Conclusion: On average, care costs amounted for more than 50% of the total costs, and even for patients with good functional status before the hip fracture, care costs amounted to 40% as compared to hospital costs of 38%. To reduce the financial costs of hip-fractures for the care sector, the results point to the importance of preventive programs to reduce the risk of a hip fracture, but also to the importance of comprehensive geriatric care in the initial phase after a hip fracture.

Health care services and costs after hip fracture, comparing conventional versus standardised care: A retrospective study with 12-month follow-up

“…These findings are similar to those of a study of comprehensive geriatric care, involving a healthier home-dwelling study population, in which 25% went home directly [19] . In that study, there was a total 12-month mean cost per patient of EUR 68 376, somewhat lower than that of the present study, probably due to the better health in their group of patients [23] .…”

Short and long-term clinical effectiveness and cost-effectiveness of a late-phase community-based balance and gait exercise program following hip fracture. The EVA-Hip Randomised Controlled Trial

“…Hip fracture in old age represents a dramatic change in life situation [1, 2] and triggers increased use of health and care services [3, 4]. Despite recent advances in peri-operative care, hip fractures are still associated with severe decline in gait and mobility, increased risk of disability, new falls, dependency, admittance to nursing home, and excessive mortality up to ten years following the fracture [5, 6].…”

Preliminary effect and feasibility of physiotherapy with strength training and protein-rich nutritional supplement in combination with anabolic steroids in cross-continuum rehabilitation of patients with hip fracture: protocol for a blinded randomized controlled pilot trial (HIP-SAP1 trial)

“…As such, a hip fracture often leads to loss of independence, change of residence, further fractures, and high mortality rates [9–13]. Thus, hip fractures pose a substantial economic burden to the health care system and society in general [2, 14, 15].…”