Economic impact of periprosthetic hip fractures

D González-Martín; J L Pais-Brito; S González-Casamayor; A Guerra-Ferraz; J M González-Pérez; A Jiménez-Sosa; M Herrera-Pérez

doi:10.1016/j.recot.2022.01.008

Economic impact of periprosthetic hip fractures

Rev Esp Cir Ortop Traumatol. 2022 Nov-Dec;66(6):477-484. doi: 10.1016/j.recot.2022.01.008. Epub 2022 Apr 21.

[Article in English, Spanish]

Authors

D González-Martín¹, J L Pais-Brito², S González-Casamayor³, A Guerra-Ferraz³, J M González-Pérez⁴, A Jiménez-Sosa⁵, M Herrera-Pérez¹

Affiliations

¹ Orthopedic Surgery and Traumatology Service, Hospital Universitario de Canarias, Tenerife, Spain; Universidad de La Laguna, Tenerife, Spain.
² Orthopedic Surgery and Traumatology Service, Hospital Universitario de Canarias, Tenerife, Spain; Universidad de La Laguna, Tenerife, Spain. Electronic address: jlpais@gmail.com.
³ Orthopedic Surgery and Traumatology Service, Hospital Universitario de Canarias, Tenerife, Spain.
⁴ Universidad de La Laguna, Tenerife, Spain; Department of Economics, Accounting and Finance; Fundamentals of Economic Analysis, Universidad de La Laguna, Tenerife, Spain.
⁵ Research unit, Hospital Universitario de Canarias, Tenerife, Spain.

PMID: 35466073
DOI: 10.1016/j.recot.2022.01.008

Abstract

Introduction: Hip replacement is one of the most successful operations in orthopaedic surgery. Periprosthetic hip fractures (PPHF) have very serious consequences for the patient, and they also entail a very important economic impact on healthcare systems. The aim of the study was to provide the first detailed cost analysis of PPHF in a traumatology and orthopaedics service in a third level hospital in Spain.

Methods: The study included all patients admitted between 2009 and 2019 with a diagnosis of "PPHF". We assessed hospital stay cost, total cost of the operating theatre, cost of the implants used, analyses, consultations with other specialists, rehabilitation sessions, radiological tests, microbiology, blood transfusions and other surgical operations during the same admission.

Results: 78 patients were included in the study, 49 women and 29 men, with a mean age of 78.74 years (R 45-92). 69 patients received surgical treatment, 75% had open reduction and internal fixation (ORIF), and 25% had revision surgery. The total cost was €1,139,650.17. The average cost was €14,610.90. Significantly higher costs were incurred for revision compared to ORIF treatments, admissions that lasted more than 30 days, and patients who required more than one operation during admission. The most costly factors were the hospital stay (46%), the cost of the surgery itself (35%), and the implants (24%).

Conclusions: Revision arthroplasty versus ORIF treatment, admissions lasting more than 30 days, and patients requiring more than one operation on admission incurred significantly higher costs. The average cost, from a hospital perspective, generated by a PPHF was €14,610.90. The most costly factors were, in descending order, the hospital stay, the cost of the surgery itself, and the implants. It is necessary to establish protocols and updated therapeutic algorithms in the perioperative management of PPHF in order to reduce both morbidity rates and associated costs.

Keywords: Costes hospitalarios; Economic impact; Fractura periprotésica de cadera; Hip replacement; Hospital costs; Impacto económico; Periprosthetic hip fracture; Prótesis de cadera.