Osteoporosis International

, Volume 23, Issue 3, pp 917–920

The direct cost of acute hip fracture care in care home residents in the UK

Original Article

DOI: 10.1007/s00198-011-1651-9

Cite this article as:
Sahota, O., Morgan, N. & Moran, C.G. Osteoporos Int (2012) 23: 917. doi:10.1007/s00198-011-1651-9

Abstract

Summary

Data on the true acute care costs of hip fractures for patients admitted from care homes are limited. Detailed costing analysis was undertaken for 100 patients. Median cost was £9,429 [€10,896], increasing to £14,435 [€16,681], for those requiring an upgrade from residential to nursing home care. Seventy-six percent of costs were attributable to hospital bed days, and therefore, interventions targeted at reducing hospital stay may be cost effective.

Introduction

Previous studies have estimated the costs associated with hip fracture, although these vary widely, and for patients admitted from care homes, who represent a significant fracture burden, there are limited data. The primary aim of this study was to perform a detailed assessment of the direct medical costs incurred and secondly compare this to the actual remuneration received by the hospital.

Methods

One hundred patients presenting from a care home in 2006 were randomly selected and a detailed case-note costing analysis was undertaken. This cost was then compared to the actual remuneration received by the hospital.

Results

Median cost per patient episode was £9,429 [€10,896] (all patients) range £4,292–162,324 [€4,960–187,582] (subdivided into hospital bed day costs £7,129 [€8,238], operative costs £1,323 [€1,529] and investigation costs £977 [€1,129]). Twenty-two percent of the patients admitted from a residential home required upgrading to a nursing home. In this group, the median length of stay was 31 days (mean 38, range 10–88) median cost £14,435 [€16,681]. Average remuneration received equated to £6,222 [€7,190] per patient. This represents a mean loss in income, compared to actual calculated costs of £3,207 [€3,706] per patient.

Conclusion

The median cost was £9,429 [€10,896], increasing to £14,435 [€16,681], for those requiring an upgrade from residential to nursing home care at discharge. Significant cost differences were seen comparing the actual cost to remuneration received. Interventions targeted at reducing length of stay may be cost effective.

Keywords

Hip fractureHip fracture bed daysHip fracture costs

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2011

Authors and Affiliations

  1. 1.Department of Elderly MedicineNottingham University HospitalsNottinghamUK
  2. 2.Department of Elderly MedicineLeicester University HospitalsLeicesterUK
  3. 3.Department of Trauma and OrthopaedicsNottingham University HospitalsNottinghamUK