Trends in hospital admissions for fractures of the hip and femur in England, 1989-1990 to 1997-1998.
BACKGROUND
Fractures of the hip are a major public health issue. Suggestions of a recent stabilization of age-specific admission rates would have implications for health service planning, thus we investigated this using hospital data.


METHODS
Hospital episode statistics for England, 1989-1990 to 1997-1998, were examined for admissions and deaths for fractures of the hip and femur in NHS hospitals in patients aged 45 years and over.


RESULTS
Age-standardized admission rates increased by 32 per cent between 1989-1990 and 1997-1998 in men, and by 30 per cent in women. The increase in admission rates was almost entirely confined to the period 1989-1990 to 1991-1992, with very little change after this. The proportion of admissions ending in death during the study period decreased in both men (-35 per cent) and women (-40 per cent) but this change was largely confined to the early years of the study. The number of admissions from hip and femoral fractures in people aged 65 years and over is projected to increase from about 57,300 in 1997-1998 to 69,500 by 2021-2022.


CONCLUSIONS
Age-specific rates of admission appear to be stabilizing, which is in contrast to previous trends. The lack of any decrease in hospital admission and mortality rates over the last 5 years is of concern. The management of osteoporosis-induced fractures in hospitals, the prevention and treatment of osteoporosis in primary care and the prevention of falls should be seen as priorities for the NHS to help reduce the burden of disease from osteoporosis in the elderly.
Balasegaram
S
S
Office of National Statistics, London. sooria@excite.com
Majeed
A
A
Fitz-Clarence
H
H
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004739:England / Q000453:epidemiology; D017050:Episode of Care; D005260:Female; D005265:Femoral Neck Fractures / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D005544:Forecasting; D006620:Hip Fractures / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data / Q000639:trends*; D015995:Prevalence; D013222:State Medicine