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Osteoporosis

Surgery to Repair Hip Fracture Saves Billions of $

Each year, more than 300,000 Americans — primarily adults over age 65 — sustain a hip fracture, a debilitating injury that can diminish life quality and expectancy and result in lost work days and substantial, long-term financial costs to patients, families, insurers and government agencies. Surgery, which is the primary treatment for hip fractures, successfully reduces mortality risk and improves physical function. However, little has been known about the procedure’s value and return on investment.

Now a study published in August 2014 in the journal Clinical Orthopaedics and Related Research found that average lifetime societal benefits in the U.S. reduced the direct medical costs of hip fracture surgery by $65,000 to $68,000 per patient (in 2009 dollars), and that total, lifetime societal savings exceeded $16 billion for older patients. These savings resulted from a reduction in the length and intensity of care after the injury, as well as a reduction in the amount of longer-term medical care and assistance needed by patients who undergo surgery for a hip fracture, when compared with those who are treated without surgery.

A release from the American Academy of Orthopaedic Surgeons quotes co-author John Tongue MD as saying, “Not only is surgery extremely successful in returning hip fracture patients to active, independent living, but the procedure also provides a significant societal benefit and value. These are important findings as the nation ages, and as policy makers and payers increasingly focus on the rising costs of health care.”

Hip fracture surgery gave Jimmy Ming Hsu his “normal life back.” Hsu fractured his hip when he fell in the shower during a trip out of the country. He immediately flew back to New York City where his hip was surgically reset. “The results were wonderful,” said Hsu. The surgery “helped me regain mobility and get my life back.”
This study showed that surgery to repair a hip fracture produced an average increase of 2.5 quality -adjusted life years (QALYs) ─ based on a patient’s life expectancy and level of physical function ─ for patients with intracapsular fractures, and 1.9 years for patients with extracapsular fractures. “Our study quantifies the economic value of surgical treatment of hip fractures in terms of reduced lifetime medical costs to society,” said Dr. Tongue.

The risk for hip fractures, a break in the upper quarter of the femur (thigh) bone, increases substantially with age with approximately 90 percent of hip fractures occurring in people older than age 65. As the number of older Americans continues to grow, the incidence of hip fracture is expected to increase substantially. The article stated that the annual incidence of hip fractures is expected to exceed 500,000 by 2040.

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