One-third of hip fracture patients undergo replacement surgery

Patients 65 and older account for almost 90% of hospital stays for hip fractures.

One-third of Americans hospitalized for hip fracture in 2003 went on to have hip replacement surgery, according to statistics recently released by the U.S. Agency for Healthcare Research and Quality. A total of 310,000 Americans were hospitalized with hip fractures in 2003.

The findings show the high costs and consequences of hip fracture, especially among patients age 65 years and older.

The data from the Agency for Healthcare Research and Quality (AHRQ), part of the U.S. Dept. of Health and Human Services, also showed the following:

Hospitals billed Medicare and other insurers almost $9.2 billion for hip fracture care, including hip fracture surgery patients’ hospital stays.
The average hospital stay for hip fracture cost $30,000, almost 50% more than the average hospital stay overall.
Patients 65 and older accounted for almost 90% of all hospital stays for hip fracture.
Almost 75% of all hip fracture patients were women.
Eighty percent of hip fracture patients were admitted through hospital emergency rooms.
Three of four hip fracture patients were discharged to nursing homes or rehabilitation facilities.

“We try to provide these national statistics to inform media, clinicians and policy and decision makers at all levels of health care,” Senior Research Physician Claudia Steiner, MD, MPH, told Orthopedics Today. Steiner is with AHRQ’s Healthcare Cost and Utilization Project.

“The way the statistics were run, partial and total hip replacement were placed together, so I cannot discern whether they were more total or partial ... . This is not a report from a full research project, but rather aggregate national statistics from HCUPnet,” she said. (HCUPnet is an online query system.)

Hip statistics

AHRQ researcher Anne Elixhauser provided additional statistics on hip fracture patients who also had hip replacement, as follows:

One-third (101,800) of hip fracture patients received hip replacements.
The mean hospital stay for hip fracture patients was 6.7 days, compared to 6.5 days for all hip fracture patients and 6.2 days for those receiving other treatment.
Mean charges for hip replacement patients were $35,000, compared to $30,000 for all hip fractures.
Among hip replacement patients, 2.9% died while in the hospital, compared with 3% of all hip fractures and 2% of those who had treatment other than hip replacement.

Overall hip replacement data

Steiner also cited overall statistics for all hip replacement patients — both partial and total replacements combined. Hip replacement patients had a primary diagnosis of osteoarthritis, followed closely by hip fracture, she said. Other notable data included the following:

A total of 340,350 patients (62.74% women, 36.78% men) were discharged from hospitals.
The mean hospital stay was 5.2 days.
In-hospital deaths totaled 3850 (1.13%).
Mean charges were $36,050; mean costs were $13,824; and aggregate costs were $4.7 billion.
Mean hospital stays were five days for men and 5.3 days for women.
A total 1595 males (1.27%) and 2256 of females (1.06%) died in hospitals.

AHRQ researchers conducted the study using HCUPnet, an online query system that provides access to health statistics and information on hospital stays from AHRQ’s Healthcare Cost and Utilization Project (HCUP). HCUPnet uses an array of heath care databases and software provided through a federal-state-private industry partnership. HCUPnet has the largest set of databases on all patients in the United States, regardless of their insurance type or whether they are insured.

For more information:
Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project: Web site: www.ahrq.gov/data/hcup.