Hip Fractures pp 303-312 | Cite as

Economics of Hip Fracture Treatment

  • Kenneth J. Koval
  • Joseph D. Zuckerman

Abstract

Health care expenditures have risen at an alarming rate worldwide over the past 30 years. The situation is most critical in the United States, which presently spends 12% of its gross domestic product on health care.1 Between 1950 and 1989, U.S. health-care costs rose from less than $13 billion to over $600 billion.1 In this context, it is important to recognize that the economic impact of hip fractures extends beyond the individual patient to affect our entire society. In this era of cost-consciousness and the limitations imposed by fiscal constraints, our ability to understand and respond to the economic challenge provided by the increasing number of hip fractures may actually be a prototype for responding to similar health problems in the elderly.

Keywords

Gross Domestic Product Average Cost Skilled Nursing Facility Prospective Payment System Total Hospital Charge 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Pinto F. New paradigms for health care. In: Reinhardt U, Pinto F, eds. New Perspectives in Health Care Economics. London: MEDIQ Ltd, 1991:108–119.Google Scholar
  2. 2.
    Melton LJ. Epidemiology of fractures. In: Riggs BL, Melton LJ, eds. Osteoporosis: Etiology, Diagnosis and Management. New York: Raven Press, 1988:133–154.Google Scholar
  3. 3.
    Cummings S, Nevitt M. Epidemiology of hip fractures and fall. In: Kleere-Koper M, Krane S, eds. Clinical Disorders of Bone and Mineral Metabolism. New York: Mary Ann Liebert, Inc, 1989:231–236.Google Scholar
  4. 4.
    Cummings SR, Rubin SM, Black D. The future of hip fractures in the United States: numbers, costs, and potential effects of postmenopausal estrogen. Clin Orthop 1990; 252:163–166.PubMedGoogle Scholar
  5. 5.
    Schneider EL, Guralnik JM. The aging of America—impact on health care costs. JAMA 1990; 263:2335–2340.PubMedCrossRefGoogle Scholar
  6. 6.
    Norris RJ. Medical costs of osteoporosis. Bone 1992; 13:11–16.CrossRefGoogle Scholar
  7. 7.
    McCue J. Cost containment in geriatrics: economics meets reality. In: Reinhardt U, Pinto F, eds. New Perspectives in Health Care Economics. London: MEDIQ Ltd, 1991:78–9.Google Scholar
  8. 8.
    Fries JF, Koop CE, Beadle CE, et al. Reducing health care costs by reducing need and demand for medical services. N Engl J Med 1993; 329:321–325.PubMedCrossRefGoogle Scholar
  9. 9.
    Clark AP, Shuttinga JE. Targeted estrogen/progesterone replacement therapy for osteoporosis: calculation of health care costs. Osteoporos Int 1992; 2:195–200.PubMedCrossRefGoogle Scholar
  10. 10.
    Eiskjaer S, Ostgard SE, Jakobsen BW, et al. Years of potential life lost after hip fracture among postmenopausal women. Acta Orthop Scand 1992; 63:293–296.PubMedCrossRefGoogle Scholar
  11. 11.
    Praemer A, Furner S, Rice DP. Musculoskeletal Conditions in the United States. Chicago: American Academy of Orthopedic Surgeons, 1992.Google Scholar
  12. 12.
    Beck TS, Brinker MR, Daum WJ. In-hospital charges associated the treatment of adult femoral neck fractures. Am J Orthop 1996; 25:608–612.PubMedGoogle Scholar
  13. 13.
    Brainsky A, Glick H, Lydick E, et al. The economic cost of hip fractures in community-dwelling older adults: a prospective study. J Am Geriatr Soc 1997; 45:281–287.PubMedGoogle Scholar
  14. 14.
    French FH, Torgerson TJ, Porter RW. Cost analysis of fracture of the neck of the femur. Age Ageing 1995; 24:185–189.PubMedCrossRefGoogle Scholar
  15. 15.
    Borgquist L, Lindelow G, Thorngren KG. Costs of hip fracture: rehabilitation of 180 patients in primary health care. Acta Orthop Scand 1991; 62:39–48.PubMedCrossRefGoogle Scholar
  16. 16.
    Zethraeus N, Stromberg L, Jonsson B, et al. The cost of a hip fracture. Estimates for 1,709 patients in Sweden. Acta Orthop Scand 1997; 68:13–17.PubMedCrossRefGoogle Scholar
  17. 17.
    Sernbo I, Johnell O. Consequences of a hip fracture: a prospective study over 1 year. Osteoporos Int 1993; 3:148–153.PubMedCrossRefGoogle Scholar
  18. 18.
    Barrett-Connor E. The economic and human costs of osteoporotic fracture. Am J Med 1995; 98:271–9.CrossRefGoogle Scholar
  19. 19.
    Kanis JA. The incidence of hip fractures in Europe. Osteoporos Int 1993; 3 (suppl 1):10–15.PubMedCrossRefGoogle Scholar
  20. 20.
    Phillips S, Fox N, Jacobs J, Wright WE. The direct medical cost of osteoporosis for American men and women aged 45 and older. Bone 1988; 9:271–279.PubMedCrossRefGoogle Scholar
  21. 21.
    Fitzgerald JF, Moore PS, Dittus RS. Changing patterns of hip fracture care before and after implementation of the prospective payment system. N Engl J Med 1988; 319:1392–1397.PubMedCrossRefGoogle Scholar
  22. 22.
    Kahn KL, Keeler EB, Sherwood MJ. Comparing outcomes of care before and after implementation of the DRG-based prospective payment system. JAMA 1990; 264:1984–1988.PubMedCrossRefGoogle Scholar
  23. 23.
    Palmer RM, Saywell RM, Zollinger TW. The impact of the prospective payment system on the treatment of hip fractures in the elderly. Arch Intern Med 1989; 149:2237–2241.PubMedCrossRefGoogle Scholar
  24. 24.
    Schroder H. The cost of hospitalizing hip fracture patients has increased despite shorter hospitalization time. Injury 1991; 22:135–138.PubMedCrossRefGoogle Scholar
  25. 25.
    Stromberg L, Ohlen G, Svensson O. Prospective payment systems and hip fracture treatment costs. Acta Orthop Scand 1997; 68:6–12.PubMedCrossRefGoogle Scholar
  26. 26.
    Cooney LM. Do we understand the true cost of hip fractures? J Am Geriatr Soc 1997; 45:382–383.PubMedGoogle Scholar
  27. 27.
    Chrischilles EA, Butler CD, Davis CS, Wallace R. A model of lifetime osteoporosis impact. Arch Intern Med 1991; 151:2026–2032.PubMedCrossRefGoogle Scholar
  28. 28.
    Holbrook TL, Grazier K, Kilsey JL. The frequency, occurrence, impact and cost of selected musculoskeletal conditions in the U.S. Paper presented at the annual meeting of the American Academy of Orthopaedic Surgeons, Chicago, IL, 1984.Google Scholar
  29. 29.
    Kramer AM, Steiner JF, Schlenker RE, et al. Outcomes and cost after hip fracture and stroke. A comparison of rehabilitation settings. JAMA 1997; 277:396–404.PubMedCrossRefGoogle Scholar
  30. 30.
    Koval KJ, Aharonoff GB, Su ET, Zuckerman JD. Effect of acute inpatient rehabilitation on outcome after fracture of the femoral neck or intertrochanteric fracture. J Bone Joint Surg Am 1998; 80:357–364.PubMedGoogle Scholar
  31. 31.
    Jensen JS, Bagger J. Long term social prognosis after hip fractures. Acta Orthop Scand 1982; 53:97–101.PubMedCrossRefGoogle Scholar
  32. 32.
    Magaziner J, Simonsick EM, Kashner TM, et al. Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol 1990; 45:M101–107.CrossRefGoogle Scholar
  33. 33.
    La Puma K, Lawlor EF. Quality-adjusted life-years: ethical implications for physicians and policy makers. JAMA 1990; 263:2917–2921.PubMedCrossRefGoogle Scholar
  34. 34.
    Parker MJ, Myles JW, Anand JK, Drewett R. Cost-benefit analysis of hip fracture treatment. J Bone Joint Surg Br 1992; 74:261–264.PubMedGoogle Scholar
  35. 35.
    Farnworth MG, Kenny P, Shiell A. The costs and effects of early discharge in the management of fractured hip. Age Ageing 1994; 23:190–194.PubMedCrossRefGoogle Scholar
  36. 36.
    Jensen JS, Tondevold E. A prognostic evaluation of the hospital resources required for the treatment of hip fractures. Acta Orthop Scand 1980; 51:515–522.PubMedCrossRefGoogle Scholar
  37. 37.
    Kennie DC, Reid J, Richardson IR. Effectiveness of geriatric rehabilitative care after fractures of the proximal femur in elderly women: a randomized clinical trial. BMJ 1988; 297:1083–1085.PubMedCrossRefGoogle Scholar
  38. 38.
    Zuckerman JD, Sakales SK, Fabian DR, Frankel VH. Hip fractures in geriatric patients. Results of an interdisciplinary hospital care program. Clin Orthop 1992; 274:213–225.PubMedGoogle Scholar
  39. 39.
    Hollingsworth W, Todd C, Parker M, Roberts J, Williams R. Cost analysis of early discharge after hip fracture. BMJ 1993; 307:903–906.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2000

Authors and Affiliations

  • Kenneth J. Koval
    • 1
    • 2
  • Joseph D. Zuckerman
    • 1
    • 2
  1. 1.Department of Orthopaedic SurgeryNYU — Hospital for Joint DiseasesUSA
  2. 2.Orthopaedic SurgeryNYU School of MedicineUSA

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