In-Hospital Costs of Hemiarthroplasty in Patients with Osteoporotic Femoral Neck Fracture at Faculty of Medicine Siriraj Hospital

Abstract

Background: The medical cost of osteoporotic hip fracture has become a great burden for the healthcare system. In Thailand, studies on the costs of bipolar hemiarthroplasty treatment for osteoporotic femoral neck fractures are limited and not up to date. Objective: To evaluate the in-hospital costs of treating the elderly with osteoporotic femoral neck fractures receiving hemiarthroplasty treatment. Materials and Methods: Patients with hip fractures who were 60 years or older and underwent bipolar hemiarthroplasty were prospectively observed. All patients were managed according to the Siriraj hip fracture fast-track and Fracture Liaison Service protocols. The authors collected details of the in-hospital costs incurred during the admission period and identified factors associated with an increasing in these costs. Results: Between February 1 and July 31, 2020, 50 patients were enrolled in the present study. Their average age was 78.3 years, and most had a Charlson comorbidity index of more than 5. The median total in-hospital costs for treatment were 5,013.25 USD with a range of 3,695.05 to 13,193.77 USD. Most of the total in-hospital costs occurred intraoperatively, with 29% of the total costs related to the cost of a prosthesis. The factors associated with an increase in costs were the length of stay (probability p<0.001) and postoperative pneumonia (p=0.038). Conclusion: In-hospital costs of hip fracture have become a great burden for patients and caregivers. Strategies to reduce total costs during hospitalization should focus on early surgery coupled with rehabilitation, which results in shorter stays. Keywords: Cost analysis; Femoral neck fracture; Hemiarthroplasty; In-hospital costs