Association of hospital resource use with comorbidity status and patient age among hip fracture patients in Japan

Abstract

Objectives: This study examined the association of resource use with comorbidity status and patient age among hip fracture patients who underwent surgical treatment. Design: We used a database from the Voluntary Hospitals of Japan Quality Indicator Project that involved 10 privately owned leading teaching hospitals in Japan. Setting: Four of these hospitals in Japan. Participants: We selected 778 operable hip fracture patients aged 65 or older who were admitted to these hospitals between January 1996 and August 2000 (mean age: 80.3±7.3 years). Measurements: A linear mixed model was performed to identify factors associated with the resource use, such as total length of stay (LOS), LOS before surgery, LOS after surgery, total hospital charges, charges for diagnostic examinations, charges for surgery, and length of theater time, among operable hip fracture patients. Results: The mean LOS was 45.9 days, and the mean total hospital charges were US$14,495.0. Results from linear mixed models revealed that higher age was significantly associated with shorter length of theater time ( P < 0.01), and that the presence of comorbidity among hip fracture patients was significantly associated with longer total LOS ( P < 0.01), longer LOS after surgery ( P < 0.001), higher charges for diagnostic examinations ( P < 0.001), and shorter length of theater time ( P < 0.01). Conclusion: These results suggest that the presence of comorbidity among operable hip fracture patients requires greater resource use during their hospital stay, but higher age is not significantly associated with greater resource use at all.