Estimating hip fracture morbidity, mortality and costs.
OBJECTIVE
To estimate lifetime morbidity, mortality, and costs from hip fracture incorporating the effect of deficits in activities of daily living.


METHODS
Markov computer cohort simulation considering short- and long-term outcomes attributable to hip fractures. Data estimates were based on published literature, and costs were based primarily on Medicare reimbursement rates.


METHODS
Postacute hospital facility.


METHODS
Eighty-year-old community dwellers with hip fractures.


METHODS
Life expectancy, nursing facility days, and costs.


RESULTS
Hip fracture reduced life expectancy by 1.8 years or 25% compared with an age- and sex-matched general population. About 17% of remaining life was spent in a nursing facility. The lifetime attributable cost of hip fracture was $81,300, of which nearly half (44%) related to nursing facility expenses. The development of deficits in ADLs after hip fracture resulted in substantial morbidity, mortality, and costs.


CONCLUSIONS
Hip fractures result in significant mortality, morbidity, and costs. The estimated lifetime cost for all hip fractures in the United States in 1997 likely exceeded $20 billion. These results emphasize the importance of current and future interventions to decrease the incidence of hip fracture.
Braithwaite
R Scott
RS
Section of Decision Sciences and Clinical Systems Modeling, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, PA 15213, USA. Braithwaiters@msx.upmc.edu
Col
Nananda F
NF
Wong
John B
JB
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D017281:Cost of Illness; D017048:Health Care Costs; D006620:Hip Fractures / Q000150:complications / Q000191:economics* / Q000401:mortality*; D006801:Humans; D008017:Life Expectancy; D008390:Markov Chains; D006278:Medicare; D009735:Nursing Homes / Q000191:economics / Q000706:statistics & numerical data; D013997:Time Factors; D014481:United States