Surgery is the primary treatment for hip fractures – which are sustained by more than 300,000 Americans each year – but little is known about the value of this procedure or its return on investment. A new study, published in the journal Clinical Orthopaedics and Related Research, investigates.
Surgery to repair a hip fracture produced an average increase of 2.5 quality-adjusted life years for patients with intracapsular fractures, and 1.9 years for patients with extracapsular fractures.
Hip fracture rates increase exponentially with age, so as the US population ages, the incidence of hip fracture is set to increase substantially.
Previous research estimates that, by 2040, the annual incidence of hip fractures will be more than 500,000, which is 200,000 more than the current rates. This increase is expected to place significant financial burden on patients, families, insurers and the government.
Because surgery reduces mortality risk and improves physical functioning for patients, it is the main treatment for hip fracture. But with policy makers and payers focusing increasingly on value, the researchers behind the new study wanted to investigate the economic returns from investment in surgery for hip fracture.
In the study, the researchers took into account long-term medical costs, home modifications costs and costs associated with long-term nursing home care. From these factors, they estimated the impact of surgical and nonsurgical treatment in patients aged 65 and older.
The study found that the average per-patient savings for surgery compared with nonsurgical treatment were $65,279 for surgery to correct a displaced intracapsular hip fracture (occurring at the neck or head of the femur) and $67,964 for a displaced extracapsular hip fracture (occurring farther down the bone).
Also, the researchers suggest that the costs for both displaced intracapsular fractures and extracapsular fractures are offset by savings from long-term medical costs.
Overall, the lifetime cost of a hip fracture was estimated by the researchers to be $81,300, 44% of which is associated with nursing facility expenses.
The lifetime per-patient societal savings from surgical treatment of hip fractures was estimated to be $160,000. For the over-65 population as a whole, the annual total savings was estimated to be $16 billion.
The study also found that surgery to repair a hip fracture produced an average increase of 2.5 quality-adjusted life years for patients with intracapsular fractures and 1.9 years for patients with extracapsular fractures.
Surgery provides ‘a significant societal benefit and value’
“Our study quantifies the economic value of surgical treatment of hip fractures in terms of reduced lifetime medical costs to society,” says orthopedic surgeon and co-author of the study Dr. John Tongue.
“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,” he adds. “These are important findings as the nation ages, and as policy makers and payers increasingly focus on the rising costs of health care.”
Back in February, Medical News Today reported on a study published in JAMA that found home-based exercise programs may improve hip fracture recovery.
That study observed that participants who carried out the home exercise program had significant improvement in physical function and balance, compared with a group who received cardiovascular nutritioneducation.
Written by David McNamee