A total of 146 patients were identified from a prospective database of all hip fractures over a 10-year period at a United Kingdom teaching hospital. The financial costs were calculated and analysed and then compared with the money recovered through the tariff produced by Payment by Results.
A total of 62% of the study group were female; mean age of 79 years; mean length of stay of 39 days. Fractures occurred around total hip replacement (THR) in 63 cases, revision THR in 27 cases and hemiarthroplasty in 56 cases. Fixation of the fracture was performed in 61 cases, revision arthroplasty in 62 cases and 23 were treated non-operatively.
The mean cost of treatment was £23,469 per patient (range £615–£223,000; median £18,031). Ward costs were responsible for 80.3%, theatre costs 5.7%, implants 6.7% and investigations 7.3%. The difference in cost was statistically significant when further surgery was required (p = 0.01) and length of stay was greater than 30 days (p < 0.0001), and when compared with the money recovered by the Trust (mean £3702; p < 0.0001). These results reveal the significant economic impact of treating this group of patients at specialist centres.
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Accepted: June 9, 2010
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.