Temporal trends in acute care costs of hip fracture treatment from 2011 to 2021 in Japan

Summary

We investigated annual trends in acute care costs for hip fracture treatment in Japan from 2011 to 2021. While gross medical costs and costs per hospitalization initially declined, both increased after 2013 and 2014, respectively. In contrast, daily medical costs per person rose steadily throughout the study period.

Purpose

Hip fractures impose a substantial financial burden on healthcare systems, primarily due to acute-care hospitalization costs. Despite efforts over the past decade to improve hospital efficiency, trends in acute care costs for hip fracture treatment remain unclear. This study aimed to evaluate annual trends in these costs in Japan.

Methods

We conducted a nationwide retrospective cohort study using the Diagnosis Procedure Combination database in Japan. Patients aged ≥ 60 years who underwent hip fracture surgery between 2011 and 2021 were included. Primary outcomes were gross medical costs, costs per hospitalization, and daily medical costs per person. Secondary outcomes were length of hospital stay and waiting times for surgery.

Results

A total of 839,179 hip fracture cases were identified. Gross medical costs decreased from $890 million in 2011 to $830 million in 2013 but increased to $989 million in 2021. Medical costs per hospitalization declined from $11,587 in 2011 to $11,337 in 2014 and rose to $12,019 in 2021. In contrast, daily medical costs per person increased steadily from $378 to $442 over the study period. Both the mean hospital stay (37.1 to 33.1 days) and waiting times for surgery (3.5 to 3.0 days) decreased from 2011 to 2021.

Conclusion

Although hospital efficiency improved, initial decreases in gross costs and costs per hospitalization were followed by gradual increases after 2013 and 2014, respectively. Meanwhile, daily medical costs per person consistently increased, underscoring the sustained economic burden of acute hip fracture care.