Trends in hospital care for hip fractures
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
To assess the impact of the aging population on the occurrence of fragility fractures, we examined hospital discharges for hip fracture among U.S. women and men aged 45 years and older from 1993 through to 2003. The number of hospitalizations declined by 5%, and age-adjusted rates fell by over 20% for both women and men during this period.
Although the aging of the population should mean an increasing burden of fragility fractures, several recently published reports suggest regional declines in the incidence of hip fracture. We investigated trends in hospital discharges and utilization for hip fractures across the USA from 1993 to 2003.
Hospital discharges from the Nationwide Inpatient Sample from 1993 through to 2003 were analyzed for numbers of primary diagnosis of hip fracture and associated average length of stay (LOS) and charges among women and men aged 45 years and older. Age-specific rates were constructed using national census data.
Over the 11-year study period the number of hospitalizations for hip fractures decreased by 5%, from 296,000 to 281,000. The numbers of discharges declined by 16,600 (7.4%) for women and increased by 1900 (2.6%) among men. However, age-adjusted rates for both women and men fell by about 20%. Average hospital LOS was reduced by about 35% for both sexes, resulting in decreases in days of care of 42 and 33% for women and men, respectively. At the same time, average inflation-adjusted charges for each hospitalization grew by 35% for women and 38% for men, and increasing proportions of patients were discharged to continuing institutional care. During the study interval the total number of prescriptions per year for bisphosphonate anti-resorptive agents grew from under 0.5 to 30 million.
Despite the increasing size of the older segment of the U.S. population, hospitalizations for hip fractures are not increasing. With declining lengths of stay there has been a reduced demand on hospital resources, although with average charges per hospitalization rising and more patients being discharged to other institutions for continuing care the economic consequences of hip fracture continue to increase.
- Fang, J, Freeman, R, Jeganathan, R, Alderman, MH (2004) Variations in hip fracture hospitalization rates among different race/ethnicity groups in New York City. Ethnic Dis 14: pp. 280-284
- Zingmond, DS, Melton, LJ, Silverman, SL (2004) Increasing hip fracture incidence in California hispanics, 1983 to 2000. Osteoporos Int 15: pp. 603-610 CrossRef
- National Center for Health Statistics (1998, 2000, 2002, 2003, 2004). National Center for Health Statistics, Hyattsville, Md.
- Agency for Healthcare Research and Quality (AHRQ). Healthcare Cost and Utilization Project (HCUP). HCUP, Rockville, Md. (http://www.ahrq.gov/data/hcup/)
- Population Estimates Program, Population Division, U.S. Census Bureau, Washington D.C.
- IMS Health. National Prescription Audit Plus, Plymouth Meeting, Pa.
- Jaglal, SB, Weller, I, Mamdani, M (2005) Population trends in BMD testing, treatment, and hip and wrist fracture rates: are the hip fracture projections wrong?. J Bone Miner Res 20: pp. 898-905 CrossRef
- Chang, KP, Center, JR, Nguyen, TV, Eisman, JA (2004) Incidence of hip and other osteoporotic fractures in elderly men and women: Dubbo Osteoporosis Epidemiology Study. J Bone Miner Res 19: pp. 532-536 CrossRef
- Black, DM, Thompson, DE, Bauer, DC (2000) Fracture risk reduction with alendronate in women with osteoporosis: the Fracture Intervention Trial. FIT Research Group. J Clin Endocrinol Metab 85: pp. 4118-4124 CrossRef
- McClung, MR, Geusens, P, Miller, PD (2001) Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group. N Engl J Med 344: pp. 333-340 CrossRef
- Nguyen, ND, Eisman, JA, Nguyen, TV (2006) Anti-hip fracture efficacy of bisphosphonates: a Bayesian analysis of clinical trials. J Bone Miner Res 21: pp. 340-349 CrossRef
- Stafford, RS, Drieling, RL, Hersh, AL (2004) National trends in osteoporosis visits and osteoporosis treatment, 1988–2003. Arch Intern Med 164: pp. 1525-1530 CrossRef
- Elliot-Gibson, V, Bogoch, ER, Jamal, SA, Beaton, DE (2004) Practice patterns in the diagnosis and treatment of osteoporosis after a fragility fracture: a systematic review. Osteoporos Int 15: pp. 767-778 CrossRef
- Trends in hospital care for hip fractures
Volume 18, Issue 5 , pp 585-591
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Population studies
- Industry Sectors