Surgery to repair a hip fracture reduces lifetime health care costs by more than $65,000 per patient

August 26, 2014, American Academy of Orthopaedic Surgeons

Each year, more than 300,000 Americans, primarily adults over age 65, sustain a hip fracture, a debilitating injury that can diminish life quality and expectancy, and result in lost work days and substantial, long-term financial costs to patients, families, insurers and government agencies. And while surgery, the primary treatment for hip fractures, successfully reduces mortality risk and improves physical function, little is known about the procedure's value and return on investment.

A new study, appearing in the journal Clinical Orthopaedics and Related Research, found that average lifetime societal benefits in the U.S. reduced the direct medical of surgery by $65,000 to $68,000 per patient (in 2009 dollars), and that total, lifetime societal savings exceeded $16 billion for older patients. These savings resulted from a reduction in the length and intensity of care after the injury, as well as a reduction in the amount of longer-term medical care and assistance needed by patients who undergo surgery for a hip fracture, when compared with those who are treated without surgery.

"Not only is surgery extremely successful in returning hip fracture patients to active, independent living, but the procedure also provides a significant societal benefit and value," said orthopaedic surgeon John Tongue, MD, co-author of the study, "Surgery for Hip Fractures Yields Societal Benefits that Exceed the Direct Medical Costs."

"These are important findings as the nation ages, and as policy makers and payers increasingly focus on the rising costs of health care," said Dr. Tongue.

Hip fracture surgery gave Jimmy Ming Hsu his "normal life back." Hsu fractured his hip when he fell in the shower during a trip out of the country. He immediately flew back to New York City where his hip was surgically reset. "The results were wonderful," said Hsu. The surgery "helped me regain mobility and get my life back."

This study showed that surgery to repair a hip fracture produced an average increase of 2.5 quality -adjusted life years (QALYs)—based on a patient's life expectancy and level of physical function—for patients with intracapsular fractures, and 1.9 years for patients with extracapsular fractures. "Our study quantifies the economic value of surgical treatment of hip fractures in terms of reduced lifetime medical costs to society," said Dr. Tongue.

The risk for hip fractures, a break in the upper quarter of the femur (thigh) bone, increases substantially with age with approximately 90 percent of hip fractures occurring in people older than age 65. As the number of older Americans continues to grow, the incidence of hip fracture is expected to increase substantially. The article stated that the annual incidence of hip fractures is expected to exceed 500,000 by 2040.

In this study, researchers estimated the impact of surgical and nonsurgical treatment in patients, age 65 and older, based on a comprehensive set of outcomes, including long-term medical costs, home modification costs and costs associated with long-term nursing home care. Based on a literature review, analysis of Medicare claims data and the input of a panel of clinical experts, the researchers created a Markov model—a standard predictive tool that accounts for various possible outcomes—to measure the cost and potential savings of repairing hip fractures via surgery.

The specific findings included:

  • The average per-patient savings was $65,279 for surgery to correct a displaced intracapsular hip fracture (occurring at the neck or head of the femur), and $67,964 for a displaced extracapsular hip fracture (occurring farther down the bone), when compared to nonsurgical treatment.
  • While surgical costs for a displaced intracapsular fracture were estimated to be $19,710 greater than nonoperative treatment, and $22,317 more for an extracapsular fracture, costs for both procedures were offset by savings from lower long-term : $84,990 for intracapsular fractures and $90,281 for extracapsular fractures.
  • The lifetime cost of a hip fracture is estimated at $81,300, of which approximately 44 percent of the costs were associated with nursing facility expenses.
  • The lifetime total per-patient societal savings from surgical treatment of hip fractures was estimated at $160,000.
  • For the population over age 65 as a whole, the annual total societal savings is estimated at $16 billion.

Explore further: Hong Kong study shows lower survival rates after second hip fractures

More information: The full study, which received financial support from the American Academy of Orthopaedic Surgeons (AAOS), is available at ANation InMotion.org/value/hip-fracture

Related Stories

Hong Kong study shows lower survival rates after second hip fractures

December 15, 2013
Research presented today at the 4th Asia-Pacific Osteoporosis Meeting showed that second hip fractures are more deadly than first hip fractures. Based in Hong Kong, the study evaluated the overall incidence of a second hip ...

Wrist fracture significantly raises risk of hip fracture

December 13, 2013
A new study presented today at the IOF Regionals 4th Asia-Pacific Osteoporosis Meeting in Hong Kong supports widespread evidence that individuals who have suffered a fracture are at significantly increased risk of subsequent ...

The deadly news about all osteoporotic fractures

November 27, 2013
It is well known that hip and vertebral fractures increase the risk of premature death. Until now, little has been known about the clinical impact of non-hip, non-vertebral fractures – so new Australian research showing ...

Undiagnosed neurological disorders may cause falls and hip fractures in the elderly

February 9, 2012
Hip fractures are a common cause of morbidity and mortality in elderly patients. Cervical myelopathy is a common neurological condition that can diminish balance and coordination.

Best anticoagulants after orthopedic procedures depends on type of surgery

July 17, 2014
Current guidelines do not distinguish between aspirin and more potent blood thinners for protecting against blood clots in patients who undergo major orthopedic operations, leaving the decision up to individual clinicians. ...

Faster surgery may be better for hip fractures, study says

November 18, 2013
The speed of surgery after a hip fracture may have a significant impact on outcomes for older patients, and faster may be better, say researchers at McMaster University.

Recommended for you

Drug may help surgical patients stop opioids sooner

December 13, 2017
(HealthDay)—Opioid painkillers after surgery can be the first step toward addiction for some patients. But a common drug might cut the amount of narcotics that patients need, a new study finds.

Children best placed to explain facts of surgery to patients, say experts

December 13, 2017
Getting children to design patient information leaflets may improve patient understanding before they have surgery, finds an article in the Christmas issue of The BMJ.

Burn victim saved by skin grafts from identical twin (Update)

November 23, 2017
A man doomed to die after suffering burns across 95 percent of his body was saved by skin transplants from his identical twin in a world-first operation, French doctors said Thursday.

Is a common shoulder surgery useless?

November 21, 2017
(HealthDay)—New research casts doubt on the true effectiveness of a common type of surgery used to ease shoulder pain.

Study shows electric bandages can fight biofilm infection, antimicrobial resistance

November 6, 2017
Researchers at The Ohio State University Wexner Medical Center have shown - for the first time - that special bandages using weak electric fields to disrupt bacterial biofilm infection can prevent infections, combat antibiotic ...

Obesity increases incidence, severity, costs of knee dislocations

November 3, 2017
A new study of more than 19,000 knee dislocation cases in the U.S. between 2000 and 2012 provides a painful indication of how the nation's obesity epidemic is changing the risk, severity and cost of a traumatic injury.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.