No ticking time bomb: hospital utilisation of 28,528 hip fracture patients in Stockholm during 1998-2007.
OBJECTIVE
The objectives were to show how utilisation of hospital care among hip fracture patients has changed in Stockholm during 1998-2007 and to explore changes in some demographic and clinical characteristics as well as surgical treatment of the patients.


METHODS
The Stockholm County Patient Care Register covers all public healthcare services in the region. All patients from 1998 to 2007 who had a hospital stay due to a hip fracture (ICD-10 codes S72.0, S72.1, S72.2) and had undergone hip surgery (NCSP codes NFB09-99 and NFJ39-99) were identified. Number of hospital stays, surgical procedures, deaths, and length of hospital stay were categorised according to age and sex, and presented as absolute and relative numbers year by year. Age- and sex-standardised annual incidence figures were calculated.


RESULTS
A total of 28,528 patients (72.2% women, 27.8% men) were hospitalised due to a hip fracture. The annual numbers decreased during the study period in all age groups except men 85 years and older. The age- and sex-standardised hip fracture incidence fell with 16%. Mortality was slightly reduced. The acute care hospital length of stay fell with 1.4 days to 7.0 days, and the whole hospital episode increased by 1.4 days to 17.3 days.


CONCLUSIONS
Despite a continued increase in the numbers of elderly during 1998-2007, the number of patients and their utilisation of hospital services remained constant and showed a marked decrease in women over 65 years of age. Comparisons with national statistics indicate that the results can be generalised to Sweden.
Löfgren
S
S
Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden. susanne.lofgren@ki.se
Ljunggren
G
G
Brommels
M
M
D000367:Age Factors; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D005593:Fracture Fixation, Internal / Q000191:economics / Q000706:statistics & numerical data; D017048:Health Care Costs; D006620:Hip Fractures / Q000453:epidemiology* / Q000401:mortality; D017052:Hospital Mortality; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data / Q000639:trends; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012042:Registries; D012737:Sex Factors; D013548:Sweden / Q000453:epidemiology