Proximal femur fracture: Direct medical costs of hospital treatment

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Sana Dorgham
Mohamed Amine Selmene
Mourad Zaraa
Ahmed Amine Lahmar
Hedi Annabi
Sabri Mahjoub

Abstract

Introduction: Proximal femur fractures are one of the most common injuries in older adults representing a serious health condition in developed as well as developing countries.


Aim: This study aimed to assess the hospitalization costs of the proximal femur fracture.


Methods: We conducted a prospective descriptive study spread over six months about patients hospitalized and operated on for proximal femur fractures. In order to estimate the cost we referred to the nomenclature of professional acts and the prices set by the Ministry of Public Health and the Ministry of Finance.


Results: The study included 100 patients, 55 females and 45 males with an average age of 76 years. The average hospital length of stay was 5 days. The preoperative stay was at a mean of three days. The average total hospitalization cost for these fractures was 2877 Tunisian Dinars depending on the type of fracture and surgical treatment. The main components of the costs were hospital stay costs and human resources costs 40%, cost of the implant 25.9%, cost of consumables 12%, operating cost 10%, cost of additional examinations 9% and cost of medications 2%.


Conclusion: Proximal femur fractures represent an important cause of health resource consumption.


To reduce the cost of hospital care, we recommend limiting the length of hospital stay as much as possible, investing in total hip and hemi-arthroplasties and adapting economical behavior taking into account the cost of consumables.

Keywords:

direct medical cost, cost of health care, proximal femur fracture

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References

  1. Solofomalala GD, Razafimahandry HC, Rakotomanga JM. Coût de la prise en charge des fractures de l’extrémité supérieure du fémur à l’hôpital universitaire Joseph Ravoahangy andrianavalona, antananarivo. Rev Med Madag. 2015;5(3):640-3.
  2. Alvarez Nebreda ML, Jiménez AB, Rodríguez P, Serra JA. Epidemiology of hip fracture in the elderly in Spain. Bone. 2008 Feb;42(2):278-85.
  3. Dictionnaire médical de l’Académie de Médecine [Internet]. Disponible sur:https://www.academiemedecine.fr/ldictionnaire/index.php?q=Garden%20%28classification%20de%29
  4. El Ayoubi A, Bouhelo KB, Chafik H, Nasri M, El idrissi M, Shimi M. Le coût médical direct de la prise en charge hospitalière des fractures de l’extrémité supérieure du fémur. Pan Afr Med J. Juin 2017;27:133.
  5. Curran D, Maravic M, Kiefer P, Tochon V, Fardellone P. Epidemiology of osteoporosis-related fractures in France: a literature review. Joint Bone Spine. 2010 Dec;77(6):546-51.
  6. Hepgüler S, Cetin A, Değer C, Erkent U. Osteoporotic hip fracture costs in the elderly turkish population. Acta Orthop Traumatol Turc. 2011;45(5):316-25.
  7. Bubshait D, Sadat Ali M. Economic implications of osteoporosis-related femoral fractures in Saudi Arabian society. Calcif Tissue Int. 2007 Dec;81(6):455-8.
  8. Clark P, Carlos F, Barrera C, Guzman J, Maetzel A, Lavielle P. Direct costs of osteoporosis and hip fracture: an analysis for the mexican healthcare system. Osteoporos Int. 2008 Mar;19(3):269-76.
  9. Mithal A, Bansal B, Kyer CS, Ebeling P. The asia-pacific regional audit-epidemiology, costs, and burden of osteoporosis in India 2013: a report of international osteoporosis foundation. Indian J Endocrinol Metab. 2014;18(4):449-54.
  10. Pareja Sierra T, Rodríguez Solis J, Alonso Fernández P, Torralba González De Suso M, Hornillos Calvo M. Geriatric intervention in elderly hip fracture patients admitted to university hospital of Guadalajara: clincal, healthcare and economical repercussions. Rev Esp Geriatr Gerontol. 2017 Jan;52(1):27-30.
  11. Lawrence TM, White CT, Wenn R, Moran CG. The current hospital costs of treating hip fractures. Injury. 2005 Jan;36(1):88‑91.
  12. Johnell O, Kanis JA, Jonsson B, Oden A, Johansson H, De Laet C. The burden of hospitalised fractures in Sweden. Osteoporos Int. 2005 Feb;16(2):222-8.
  13. Maravic M, Le Bihan C, Landais P, Fardellone P. Incidence and cost of osteoporotic fractures in France during 2001. A methodological approach by the national hospital database. Osteoporos Int. 2005 Dec ;16(12):1475-80.
  14. Lippuner K, Golder M, Greiner R. Epidemiology and direct medical costs of osteoporotic fractures in men and women in Switzerland. Osteoporos Int. 2005 Mar;16 Suppl 2:8-17.
  15. Saeb M, Beyranvand M, Basiri Z, Haghparast Bidgoli H. The hospital resource utilization associated with osteoporotic hip fractures in Kermanshah, Iran. J Inj Violence Res. 2014 Jan;6(1):16-20.
  16. Tamulaitiene M, Alekna V. Incidence and direct hospitalisation costs of hip fractures in Vilnius, capital of Lithuania, in 2010. BMC Public Health. 2012 Jul;12:495.
  17. Wong MK, Ching LK, Lim SL, Lo NN. Osteoporotic hip fractures in Singapore--costs and patient’s outcome. Ann Acad Med Singap. 2002 Jan;31(1):3-7.