Costs to the Medical System Associated With Treatment of Hip Fractures

Objective: The purpose of this study is to better understand the costs to the medical system of treating fragility fractures of the hip.

Methods: A prospective study was performed at our medical center to determine efficacy of a program for osteoporosis treatment. In parallel, an analysis was made to determine the income and expenses during the hospitalization for each patient that was entered into the study. Data was entered into the RedCAP database and qualitative analysis was done.

Results: 404 patients with hip fractures were admitted over the first year of the study. Of those admitted, 216 were eligible and 154 were enrolled (71% of those eligible).

Kupah Perspective: The average payment from the Kupah to the hospital was 33,580 NIS (range 7100 to 272,000 with median 22,990) per hip fracture. Rehabilitation adds approximately 16,800 NIS bringing the total cost per hip fracture to an average of 50,380 NIS. With at least 6000 patients, hip fractures cost the Kupah system over 303 million NIS per year.

Hospital Perspective: The hospital lost an average of 17,230NIS per hip fracture (range +6,770 to -119,500 and median -13,580). Extrapolating this cost to all 404 patients, this results in an annual loss of 6.9 million NIS to our medical center. Assuming that all the hospitals lose at the same rate, then hospitals in Israel lose at least 103 million NIS per year treating hip fractures.

Conclusions: Hip fractures are costly to the hospital. This is due in large part to the extra cost associated with the Ministry of Health requirement to operate hip fractures within 48 hours of admission. Though hip fractures are costly to the Kupot, their deficit might be state supported whereas the hospitals must balance their own budget. We suggest that reimbursement to the hospital system be re-evaluated to meet expenses.