title: Inpatient cost for hip fracture patients managed with an orthogeriatric care model in Singapore.
abstract: BACKGROUND
  The estimated incidence of hip fractures worldwide was 1.26 million in 1990 and is expected to double to 2.6 million by 2025. The cost of care for hip fracture patients is a significant economic burden. This study aimed to look at the inpatient cost of hip fractures among elderly patients placed under a mature orthogeriatric co-managed system.
  
  
  METHODS
  This study was a retrospective analysis of 244 patients who were admitted to the Department of Orthopaedics of Tan Tock Seng Hospital, Singapore, in 2011 for hip fractures under a mature orthogeriatric hip fracture care path. Information regarding costs, surgical procedures performed and patient demographics was collected.
  
  
  RESULTS
  The mean cost of hospitalisation was SGD 13,313.81. The mean cost was significantly higher for the patients who were managed surgically than for the patients who were managed non-surgically (SGD 14,815.70 vs. SGD 9,011.38; p < 0.01). Regardless of whether surgery was performed, the presence of complications resulted in a higher average cost (SGD 2,689.99 more than if there were no complications; p = 0.011). Every additional day from admission to time of surgery resulted in an increased cost of SGD 575.89, and the difference between the average cost of surgery within 48 hours and that of surgery > 48 hours was SGD 2,716.63.
  
  
  CONCLUSIONS
  Reducing the time to surgery and preventing pre- and postoperative complications can help reduce overall costs. A standardised care path that empowers allied health professionals can help to reduce perioperative complications, and a combined orthogeriatric care service can facilitate prompt surgical treatment.
authors.affiliation: Department of Orthopaedics, Tan Tock Seng Hospital, Singapore.
authors.forename: Lester Teong Jin
authors.initials: LT
authors.lastname: Tan
authors.affiliation: University of Edinburgh, Scotland, United Kingdom.
authors.forename: Seng Joung
authors.initials: SJ
authors.lastname: Wong
authors.affiliation: Department of Orthopaedics, Tan Tock Seng Hospital, Singapore.
authors.forename: Ernest Beng Kee
authors.initials: EB
authors.lastname: Kwek
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005265:Femoral Neck Fractures / Q000191:economics / Q000601:surgery; D017048:Health Care Costs; D006620:Hip Fractures / Q000191:economics* / Q000601:surgery*; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000191:economics*; D010343:Patient Admission; D012189:Retrospective Studies; D012846:Singapore; D013514:Surgical Procedures, Operative / Q000191:economics
keywords: economic costs; hip fractures; orthogeriatrics