COST-ANALYSIS OF FRACTURE OF THE NECK OF FEMUR

A detailed cost analysis of fractures of the neck of femur in elderly patients has been conducted at Aberdeen Royal Infirmary. The aims of t his study mere as follows: (1) to show that the use of average orthopa edic bed day costs can lead to an overestimation of costs; (2) to iden tify the key explanatory)r variables of hip fracture costs; and (3) to identify differences in resource consumption between patient groups. The care of 50 first and ten second (contralateral) hip fracture patie nts admitted to Aberdeen Royal Infirmary in 1993 was costed in conside rable detail. Acute care, convalescence, rehabilitation and operations accounted for more than 90% of total costs in both groups. It was fou nd that patients who were admitted from their own homes cost significa ntly more than patients who were admitted from long-term care (pound 4 018 vs. pound 2049; p < 0.001). In order to validate the costed sample s, additional data were collected on all hip fracture patients admitte d to Aberdeen Royal Infirmary in 1993. The main factors in explaining cost variation were the number of days spent in acute care and convale scence or rehabilitation [r(2) = 0.62; logcost = (0.009 x acute days) + (0.01 x rehabilitation days) + 3.213]. Age and place of residence pr ior to admission explained a further 2.8% of total costs but neither v ariable was statistically significant. When costing fractures of the n eck of femur, we recommend the collection of a minimum data set of the se four variables which account for 65% of the variation in total cost s.