OBJECTIVES : This study evaluated the rates, costs and charges for hospitalization of patients with femur fractures by its anatomy (proximal, shaft and distal).

METHODS : This retrospective observational study used Premier hospital billing database for the analysis. Patients ≥ 18 years old and diagnosed with any femur fracture in the year 2016 were identified. Patient demographic and clinical characteristics in terms of Charlson comorbidity index (CCI) and Elixhauser comorbidity score were reported. Patients were categorized into four groups based on the anatomy of the femur fractures as distal, shaft, proximal and unspecified fractures. The mean total charges and costs for hospitalization by each femur fracture category were calculated.

RESULTS : A total of 101,821 patients with femur fractures were identified. Most of the patients were aged 70 years or more (73.0%), females (67.4%), receiving hospital care in the south region (46.0%) and urban area (87.0%). There were 43.2% and 34.2% patients with a CCI score and Elixhauser score between 1 and 2, respectively. Uncomplicated hypertension, cardiac arrhythmia and dementia were the top three comorbidities among patients with femur fractures. When categorized by the anatomy, 7.1% had distal, 6.1% had shaft, 76.6% had proximal and 10.2% had unspecified femur fractures. The mean (SD) total charges calculated per hospitalization were $129,793 (208430), $173,638 (256,797), $74,698 (87,753) and $111,513 (154,261) for distal, shaft, proximal and unspecified femur fractures, respectively. The mean (SD) costs incurred per hospitalization were $32,403 (50,738), $41,911 (59,326), $ 19,404 (21,396) and $29,156 (35,289) for distal, shaft, proximal and unspecified femur fractures, respectively.

CONCLUSIONS : Most patients with femur fractures had proximal fractures. All femur fracture categories showed high costs and charges for hospitalization indicating a large healthcare economic impact both on the patient and the provider.