Retrospective database study to assess the economic impact of hip fracture in the United Kingdom

Abstract

Objective:

Publications containing recent, real-world data on the economic impact of hip fractures in the UK are lacking. This retrospective electronic medical records database analysis assessed medication and healthcare resource use, direct healthcare costs, and factors predicting increased resource use and costs in adult UK hip fracture patients.

Methods:

Data were obtained from the Clinical Practice Research Datalink linked to the Hospital Episode Statistics for adult patients hospitalized for their first hip fracture between January 1, 2006 and March 31, 2011 (index event); healthcare costs were calculated from the National Health Service perspective using 2011–2012 cost data.

Results:

Data from 8028 patients were analyzed. Resource use and costs were statistically significantly higher in the year following fracture (mean total [standard deviation (SD)] cost £7359 [£14,937]) compared with the year before fracture (mean total [SD] cost £3122 [£9435]; p < 0.001), and were similar to the total amount of the index hospitalization (mean total [SD] cost £8330 [£2627]). Multivariate regression analysis (using an estimated generalized linear model) showed that older age, male gender, higher comorbidity, osteoporosis, discharge to another institution compared with home, and pre-index hospitalization and outpatient visits were associated with increased post-index hospitalization healthcare costs (all p < 0.05).

Conclusions:

Although we did not capture all pre- and post-index costs and healthcare utilization, this study provides important insights regarding the characteristics of patients with hip fracture, and information that will be useful in burden-of-illness and economic analyses.

Keywords::

• Epidemiology
• Healthcare costs
• Hip fractures
• Healthcare resource use

Transparency

Declaration of funding

This study was funded by Eli Lilly and Company. The study sponsor participated in the data analysis.

Declaration of financial/other relationships

R. B. and M. S. are employees of and shareholders in Eli Lilly and Company. D. L., M. R-C., S. C., and N. W. are employees of Evidera, the company contracted by Eli Lilly and Company to perform this research.

Acknowledgments

The authors would like to acknowledge Sarah Smith and Caroline Spencer (Rx Communications, Mold, UK) for medical writing assistance with the preparation of this article, funded by Eli Lilly and Company. JME peer reviewers on this manuscript have no relevant financial or other relationships to disclose.