THE ECONOMIC COST OF HIP-FRACTURES IN COMMUNITY-DWELLING OLDER ADULTS- A PROSPECTIVE-STUDY

OBJECTIVES: To evaluate the incremental cost in the year after hip fra cture. DESIGN: Prospective cohort study SETTING: Baltimore, Maryland P ARTICIPANTS: 759 community dwelling older patients who sustained a hip fracture and participated in the Baltimore Hip Fracture Study. MEASUR EMENTS: Resource use for direct medical care, formal nonmedical care, and informal care in the 6 months before and the year after fracture w as estimated from interviews with patients or proxy respondents. Costs in 1993 dollars were estimated by multiplying resources times nationa l unit cost estimates. RESULTS:: The annualized costs in the year befo re the fracture ranged between $18,523 and $20,928. The costs in the y ear after the fracture equaled $37,250. The incremental costs in the y ear after the fracture, compared with the costs in the year before the fracture, ranged between $16,322 and $18,727. The largest cost differ ences were attributable to hospitalizations, nursing home stays, and r ehabilitation services. CONCLUSIONS: Because we compared the costs aft er a fracture with costs before, our estimates of the incremental cost of a hip fracture are lower than others in the literature. These resu lts, obtained from interviews with patients enrolled in a cohort study , or their proxies, provide the best data available to date on the eco nomic cost of hip fractures among community-dwelling older persons.