Cost analysis of hip fracture treatment among the elderly for the public health services: a 1-year prospective study in 106 consecutive patients.

INTRODUCTION

The most serious complication resulting from osteoporosis is fracture of the hip. This injury often has serious consequences for the patient, because it is linked to a considerable level of mortality and deterioration of functional capacity.

MATERIALS AND METHODS

The data from 106 consecutive patients with a hip fracture were registered for 1 year following the fracture by trained nurses in an area of six municipalities and 92,500 inhabitants. The total costs of these patients were calculated per patient, including the costs of acute and post-acute care and rehabilitation, home assistance and home care, outpatient visits, assistive devices, transportation, medication, and forensic autopsies as well as the patients' own share of the treatment costs. The costs were calculated according to the 2003 price level.

RESULTS

The average costs during the first post-fracture year were around euro 14,410. Slightly less than one-fourth of these costs was caused by acute care. If a previously home-dwelling patient had to be admitted to permanent institutional care after the fracture, the average costs rose to euro 35,700. The centralisation of post-acute rehabilitation lowered the amount of the total costs.

CONCLUSION

The average 1-year total costs of a patient with a hip fracture were euro 14,410. About one-fourth of the costs were caused by acute care. The centralisation of post-acute rehabilitation was profitable.