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Hemiarthroplasty a more cost-effective treatment option for femoral neck fractures
Frihagen F. Acta Orthop. doi:10.3109/17453674.2010.492763.
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The common belief is that hemiarthroplasty is too expensive a treatment for elderly patients with femoral neck fractures. However, according to the results of a randomized trial, when the total costs for treating this injury are tallied, hemiarthroplasty is the less expensive option compared with internal fixation.
For 2 years, Frede Frihagen, MD, Oslo University, and colleagues observed 222 patients who had been randomized to either internal fixation or hemiarthroplasty. Patients were aged 60 years or older; mean patient age was 83 years.
For the initial hospital stay, the average cost per patient was lower in the internal fixation group compared with the hemiarthroplasty group (9044 euros vs. 11,887 euros; P<.01). When the researchers combined all hospital costs — ie, rehabilitation, reoperations, as well as formal and informal hospital contact — the costs were similar (21,709 euros for internal fixation vs. 19,976 euros for hemiarthroplasty). However, when they combined all costs, including hospital admissions, nursing home costs and community-based care, internal fixation was the most expensive option (47,186 euros vs. 38,615 euros; P=.09).
“The initial lower average cots per patient for internal fixation as treatment for a femoral neck fracture cannot be used as an argument in favor of this treatment, since the average cost per patient is more than outweighed by subsequent costs, mainly due to a higher reoperation rate after internal fixation,” Frihagen and colleagues wrote.