Abstract
SummaryLittle is known about hip fracture expenditure in Japan. Using claims data obtained from a core city near Tokyo, we estimated the mean healthcare expenditure and monthly long-term care expenditure post-hip fracture to be ¥2,600,000 (US$29,500) and ¥113,000 (US$1290), respectively.PurposeWe aimed to estimate healthcare and long-term care expenditures post-hip fracture in Japan.MethodsHealthcare insurance claims data for adults aged ≥ 75 years were merged with long-term care insurance claims data. We analyzed the data of hip fracture patients who were admitted to non-diagnosis procedure combination/per-diem payment system (DPC/PDPS) hospitals in a core city near Tokyo between April 2012 and September 2013. We estimated healthcare expenditure, namely, the difference between total payments 6 months pre- and 6 months post-hip fracture, and monthly long-term care expenditure for those who did not use long-term care insurance pre-hip fracture, but who commenced long-term care insurance post-hip fracture. We also performed multiple linear regressions to examine the associations of healthcare or long-term care expenditure with various factors.ResultsThe estimated mean healthcare (n = 78) and monthly long-term care (n = 42) expenditures post-hip fracture were ¥2,600,000 (US$29,500) and ¥113,000 (US$1290), respectively. In multiple linear regressions, healthcare expenditure was positively associated with longer duration of hospital stay (p = 0.036), and negatively associated with higher Charlson Comorbidity Index scores (p = 0.015). Monthly long-term care expenditure was positively associated with higher care-needs level post-hip fracture (p = 0.022), and usage of institutional care services (p < 0.001).ConclusionsThis is the first study to estimate healthcare and long-term care expenditures post-hip fracture using claims data in Japan. Further studies are needed that include healthcare claims data at both DPC/PDPS and non-DPC/PDPS hospitals to capture the lifelong course of long-term care required post-hip fracture.
Highlights
The estimated annual incidence of hip fractures in Japan was 175,700 in 2012, which was markedly increased from the incidence of 53,200 in 1987 [1]
Many studies used claims data to estimate the healthcare expenditure associated with hip fractures, but no such study has been conducted in Japan
We aimed to examine the associations of healthcare or long-term care expenditure with various factors, including age, sex, baseline comorbidity, duration of hospitalization, procedure for a hip fracture, functional status at discharge, and institutional care services posthip fracture
Summary
The estimated annual incidence of hip fractures in Japan was 175,700 in 2012, which was markedly increased from the incidence of 53,200 in 1987 [1]. A hip fracture requires hospitalization and surgery but can cause a decline in functional status, eventually leading to usage of long-term care. Fractures accounted for 12% of cases in which long-term care insurance was utilized, making them the fourth leading cause in 2013, according to the Comprehensive Survey of Living Conditions that the Japanese Ministry of Health, Labour and Welfare conducts every 3 years [2]. Many studies used claims data to estimate the healthcare expenditure associated with hip fractures, but no such study has been conducted in Japan. To the best of our knowledge, no study has estimated expenditure for long-term care post-hip fracture in Japan using claims data
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