OBJECTIVES

To estimate the healthcare resource utilization associated with complications occurring within 90 days following intertrochanteric hip fracture (IHF) diagnosis.

METHODS

In this retrospective cohort study, inpatient discharges ≥65 years with a new diagnosis of IHF (ICD 9:820.21 and corresponding ICD 10 codes), alive at index discharge and with ≥6 months of continuous data were identified from the Premier Healthcare database between January 2014 and December 2017. Patients were further grouped into 4 categories based on the absence or presence of readmissions due to complications (no complication, fixation failure, immobility and pain) within 90 days following IHF. Descriptive and inferential statistics were used to describe the study population and compare patient groups by resource utilization respectively. Regression analyses adjusted for baseline characteristics; age, gender, payer type, comorbidity index, index discharge status. All analyses were conducted using SAS 9.4 (SAS Institute Inc., Cary, NC, USA)

RESULTS

The mean age (standard deviation) of the 81,971 unique patients included in the study was 82 (7.1) years, majority was female: 58,871 (72%) and had Medicare: 76,621 (93.5%) as primary payer. Multiple regression analyses showed that readmissions due to fixation failure, immobility and pain at the 90-day period following IHF occurred in 1,975 (2.4%), 45 (0.05%) and 2,163 (2.6%) patients respectively. With fixation failure, immobility and pain accounting for significantly higher total costs at $28,368 (p<0.0001), $30,557 (p<0.0001) and $25,094 (p<0.0001) respectively compared to patients (n=77,788 [94.9%]) with no readmissions ($17,679). Total hospital length of stay at the 90-day period was significantly higher in the fixation failure, immobility and pain patient groups at 12.41 days (p<0.001), 14.51 days (p<0.001) and 12.05 days (p<0.001) respectively compared to 5.47 days spent by patients with no complication.

CONCLUSIONS

Fixation failure, immobility and pain were complications associated with significantly higher costs within the 90-day period following IHF.