Comorbidities Affect Hospital Costs After Hip Fracture

Largest cost increase due to weight loss or malnutrition, then pulmonary circulation disorders

TUESDAY, Jan. 17 (HealthDay News) -- For older Americans with hip fracture, the presence of comorbidities is associated with increased cost of hospitalization, according to a study published in the Jan. 4 issue of The Journal of Bone & Joint Surgery.

Lucas E. Nikkel, of the Pennsylvania State University College of Medicine in Hershey, and colleagues identified 32,440 patients aged 55 years or older who had been diagnosed with and treated for an isolated, closed hip fracture. Data from these patients were used to evaluate whether specific comorbidities, or combinations of comorbidities, affect hospitalization costs and length of stay for older patients following hip fracture.

The investigators found that the patients had a mean of three comorbidities, and only 4.9 percent of patients did not have comorbidities. The most common comorbidities included hypertension, deficiency anemias, and fluid and electrolyte disorders. For the study's reference patient, the average estimated cost was $13,805. Most comorbidities significantly increased the hospitalization cost, with weight loss or malnutrition, followed by pulmonary circulation disorders, causing the largest increase in hospitalization costs. Costs were also significantly higher for those treated with a hip arthroplasty compared with internal fixation of the hip fracture.

"The presence of specific comorbid conditions and, to a lesser degree, the number of comorbid conditions impact hospitalization costs for older Americans following hip fracture. Accounting methods in the current reimbursement system may not adequately reflect the burden of patients with the most complex hip fractures," the authors write.

One or more of the study authors disclosed financial ties to an entity in the biomedical arena.

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