Cost of Osteoporosis-Related Hip Fractures in a Private Tertiary Hospital System

Abstract

Background: Osteoporotic fractures, especially of the hip, lead to great burden both for the patient and economy. Due to the paucity of burden of illness studies of osteoporosis in the Asian region, particularly the Philippines, it is difficult to allocate healthcare resources appropriately for fracture prevention. The availability of information on the financial burden of osteoporosis-related fractures, particularly in the local region, will create awareness of the size of the problem as well as assist healthcare authorities to initiate appropriate programs and strategies. Objective: to determine the cost of osteoporosis-related hip fractures in a private tertiary hospital. Methods: Data from the medical records of patients diagnosed with osteoporosis-related hip fractures who were hospitalized from January 1, 2017- December 31, 2019 were analyzed. The researcher recorded the patient’s demographic data, type of hip fracture, type of treatment, duration of hospitalization, and medical costs. Descriptive statistics, t-test, chi-squared test, ANOVA with Tukey HSD test and regression analysis were employed to treat and analyze the different sets of data. Results: Among the 150 patients, 44.6% were within the 80-year-old and above age group and majority (76%) were females. The most common type of osteoporotic hip fracture involved the femoral neck (52.7%) and most of the patients underwent partial hip replacement (66%). Patients 80 and above age group, those sustaining an intertrochanteric fracture and those who were treated with internal fixation had a longer length of stay in the hospital. There was note of a parallel increase in the direct medical cost as the patients age group got older. It was found that femoral neck fracture had significantly higher implant costs while the other costs (hospitalization, surgery, laboratories, and medications) were observed to be comparable between the two types of fracture. Conclusions: The overall mean cost of osteoporotic hip fracture was 5227.78 USD. The implant used on average accounted for approximately 27% of the total direct medical costs. It was noted that 26% and 23% of the total cost was attributed to the cost of surgery and hospitalization respectively. Medication costs accounted for 11% while laboratory costs comprised 13% of total costs.