Abstract

BackgroundHip fractures increase the risks of mortality and major morbidity in the elderly. Hip fractures are associated with chronic pain, reduced mobility, disability and increasing dependence. We evaluated the direct costs incurred to the Israeli healthcare system in 2013 as a result of hip fracture injuries in elderly patients.MethodsHip fractures costs evaluation consisted of first-year and long-term direct costs. Data on the incidence of hip fractures resulting in hospitalizations were retrieved from the Israeli Ministry of Health’s (MOH) Central Database of Hospital Admissions. Hospitalization, rehabilitation and nursing utilization rates and costs were estimated based on the professional literature and according to the MOH’s price list.ResultsDuring 2013, 6285 elderly patients were hospitalized in Israel due to hip fractures. Direct costs of hip fracture, comprising hospitalization, rehabilitation and nursing costs incurred during the first year after the injury, were estimated at 454 million New Israeli Shekels (NIS; 83,841 NIS per person). Long-term nursing care costs in 2013 were 265 million NIS, with an average cost of approximately 49,000 NIS for 1600 elderly persons receiving long-term nursing care as a result of a hip fracture. Overall, the total direct costs of hip fracture in the elderly population in Israel in 2013 were 719 million NIS.ConclusionsThe direct costs of hip fractures in Israel among the elderly are approximately 719 million NIS per year. The majority of costs are associated with the first year following the injury. To reduce healthcare costs in Israel, changes in the country’s healthcare policy on hip fractures are required. For example, there is a need for a program for detecting high- risk populations, and for early intervention following the injury.

Highlights

  • Hip fractures increase the risks of mortality and major morbidity in the elderly

  • Data sources Data regarding the incidence of hospitalizations as a result of hip fracture, length of stay and demographic characteristics of individuals who sustained hip fracture injuries in Israel in 2013 were retrieved from the Central Registry of Hospital Admissions, which is managed by the Israeli Ministry of Health (MOH)

  • The direct costs of hip fracture comprised the costs of hospitalization, rehabilitation and nursing costs incurred during the first year after the injury and estimated as described below

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Summary

Introduction

Hip fractures increase the risks of mortality and major morbidity in the elderly. The incidence of hip fracture increases exponentially with age in both genders, with most hip fractures occurring in the elderly [3]. Between 1990 and 2000, the peak number of hip fractures for both males and females occurred at 75–79 years of age [4]. The age-standardized incidence of hip fractures in men was approximately half that noted in women [2]. In Israel, between 1998 and 2001, the estimated annual incidence of hip fractures in individuals above 50 years of age was 402/100,000 women and 196/ 100,00 men [5]. Because of the increasing number of elderly people in the world, the total number of hip fractures in individuals 50 years and older will continue to Barnea et al Israel Journal of Health Policy Research (2018) 7:38 rise and the total number of hip fractures is expected to surpass 6 million by the year 2050 [6, 7]

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