Faculty Collaboration Database

Operative intervention for geriatric hip fracture: does type of surgery affect hospital length of stay? Am J Orthop (Belle Mead NJ) 2015 May;44(5):228-32

Date

05/08/2015

Pubmed ID

25950538

Scopus ID

2-s2.0-84953342738 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

Hip fractures are the most costly fall-related fractures. Differences in hospital length of stay (LOS) based on type of surgery could have major financial implications in a potential bundled payment system in which all hip fractures are reimbursed a standard amount. We conducted a study to analyze differences in hospital LOS and costs for total hip arthroplasty (THA), hemiarthroplasty (HA), cephalomedullary nailing, open reduction and internal fixation (ORIF), and closed reduction and percutaneous pinning (CRPP). Through retrospective chart review, 615 patients over age 60 years across a 9-year period at an urban level I trauma center were identified. Mean LOS and costs for hip fracture repair were 6.91 days and $30,011.25, respectively. HA/THA was associated with the longest mean LOS (7.43 days) and highest costs ($33,657.90). After several patient factors were adjusted for, ORIF was associated with 0.84 fewer in-patient days and $3805.20 less in hospitalization costs compared with HA/THA (P=.042). CRPP was associated with 1.63 fewer days and $7383.90 less in costs than HA/THA (P=.0076). Our results provide insight into the financial implications of hip fracture fixation and identify targets for quality improvement initiatives to improve efficiency of resource utilization.

Author List

Thakore RV, Foxx AM, Lang MF, Sathiyakumar V, Obremskey WT, Boyce RH, Ehrenfeld JM, Sethi MK

Author

Jesse Ehrenfeld MD, MPH Sr Associate Dean, Director, Professor in the Advancing a Healthier Wisconsin Endowment department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Arthroplasty, Replacement
Fracture Fixation
Health Care Costs
Hip Fractures
Humans
Length of Stay
Male
Middle Aged
Retrospective Studies