Utilization of inpatient care before and after hip fracture: a population-based study.
CONCLUSIONS
Evaluation of hospitalizations in a 70+ population showed that hip fractures (HF) were associated with a significant increase in the utilization of inpatient care for a lengthy period. Hospital days attributable to several diagnostic classes still exceeded both prefracture and population levels in the second year after HF.


BACKGROUND
The goal was to assess effects of HF on the inpatient care utilization.


METHODS
The study covered HF patients and the 70+general population (26,000) living in Central Finland. Hospitalization data categorized by the ICD-10 main classes were obtained from the nationwide discharge register.


RESULTS
In 2002-2003, 498 residents (mean age 82 SD 7, 74.9% women) of the study area sustained HF. Among them, the number of hospital days was 23, 107, and 52 per person-year in the prefracture, first and second postfracture year, respectively. In the 70+ general population, the number was constantly 11 per year. The age- and gender-adjusted rate ratio of hospital days between the two groups was 1.30 (95% CI 1.27 to 1.32), 6.91 (95% CI 6.85 to 7.00), and 3.61 (95% CI 3.55 to 3.67) for the prefracture, first and second postfracture year, respectively. Hospital days due to injuries were more prevalent in the HF group throughout the period. Moreover, excess of days was seen in six other diagnostic classes in the first and in four classes in the second postfracture year.


CONCLUSIONS
Hospital days in HF patients still exceeded both the prefracture and population levels in the second year after HF. Days attributable to several other causes than HF itself became also more prevalent indicating that HF can steeply decrease patients' coping capacity and launch a cascade of impairments in the function of different organ systems.
Lönnroos
E
E
Department of Geriatrics, Central Finland Hospital, Keskussairaalantie 19, 40620 Jyväskylä, Finland. Eija.Lonnroos@uku.fi
Kautiainen
H
H
Sund
R
R
Karppi
P
P
Hartikainen
S
S
Kiviranta
I
I
Sulkava
R
R
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005387:Finland / Q000453:epidemiology; D006620:Hip Fractures / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000453:epidemiology*; D010351:Patient Discharge / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution