Costs of care after hospital discharge among women with a femoral neck fracture

A prospective study was done among women who are postmenopausal and who had a displaced femoral neck fracture. The objective was to identify potential predictors of medical care costs during the I-year after hospital discharge, and to examine the impact of the type of surgical procedure. The design was a 1-year prospective cohort study reflecting day-to-day clinical practice. At four hospitals, 84 women 50 years or older with a displaced femoral neck fracture were enrolled on a consecutive basis. Direct costs of medical care were documented during the I-year after hospital discharge. Multivariate analyses were done to explore potential predictors of costs. Three fracture groups were defined by the time of surgical repair. Patients in the total hip arthroplasty group were significantly younger than those in the hemiarthroplasty and the internal fixation groups (mean age, 71 years, 81 years, and 80 years, respectively). The mean direct costs of medical care during the 1-year followup after hospital discharge were not significantly different after total hip arthroplasty, hemiarthroplasty, or internal fixation because of large cost variations among patients. A multivariate model identified increasing age and living in an institution at the time of the injury as the two significant determinants of increased medical costs during the 1-year followup after hospital discharge. Direct costs of medical care during the 1-year after hospital discharge do not seem to be associated with the type of surgical procedure. Increasing age and living in an institution at the time of the injury are strong predictors of increased costs.