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Hip fracture surgery reduces health care costs

by Lauren Dubinsky, Senior Reporter | September 02, 2014
Hip fracture surgery decreases lifetime health care costs by more than $65,000 per patient and also increases their quality of life, according to a new study published in the journal Clinical Orthopaedics and Related Research. This is the first study to investigate the total societal impact of hip fracture surgery.

There were 258,000 hospital admissions for hip fractures of people 65 years old and older in 2010, according to the Centers for Disease Control and Prevention. That number is expected to rise to 289,000 by 2030.

Even though surgery is the main treatment for hip fractures and it has been shown to reduce mortality risk and improve physical function, not much research has shown its financial value.

Researchers at the American Academy of Orthopaedic Surgeons used Medicare claims data and the input of a panel of experts to develop a Markov model — a standard predictive tool that details a variety of potential outcomes — in order to measure the cost and possible savings of hip fracture surgery.

They compared the long-term medical, home modification and long-term nursing home care costs for patients 65 and older who underwent surgery with the costs for patients in the same age group who did not undergo surgery.

The study found that each patient who underwent the surgery spent $65,000 to $68,000 less in medical costs in 2009 due to a reduction in the duration and intensity of care after the injury and the amount of longer-term medical care and assistance.

Additionally, the overall amount of savings for all of the patients 65 and older who underwent surgery was over $16 billion.

"Not only is surgery extremely successful in returning hip fracture patients to active, independent living, but the procedure also provides a significant societal benefit and value," Dr. John Tongue, co-author of the study and orthopaedic surgeon, said in a statement.

The researchers also investigated how the surgery affected the patients' quality of life. They measured that using quality adjusted life years, which take into account the patients' life expectancy and their level of physical function.

They found that surgery led to an average increase of 2.5 quality adjusted life years among the patients with intracapsular fractures and 1.9 years for patients with extracapsular fractures.

The researchers hope that the findings of the study and the model that they used will be applied to other medical procedures in order to educate policymakers and ensure that the maximum value will be received for health care dollars spent.

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