Cost and time of hospitalization for elderly people with bone fractures in a reference hospital

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Abstract

In Brief

This one-year retrospective study analyzed data from 156 elderly patients with bone fractures undergoing orthopedic surgery at a reference hospital. The authors observed that the longer the hospital stay for treatment, the higher the cost of care. Furthermore, the cost and the number of comorbidities and medications used were not correlated.

ABSTRACT

Objective

To describe and analyze the aspects regarding the cost and length of stay for elderly patients with bone fractures in a tertiary reference hospital.

Methods

A cross-sectional retrospective study using data obtained from medical records between January and December 2020. For statistical analysis, exploratory analyses, Shapiro-Wilk test, χ ² test, and Spearman correlation were used.

Results

During the study period, 156 elderly patients (62.2% women) with bone fractures were treated. The main trauma mechanism was a fall from a standing height (76.9%). The most common type of fracture in this sample was a transtrochanteric fracture of the femur, accounting for 40.4% of cases. The mean length of stay was 5.25 days. The total cost varied between R$2,006.53 and R$106,912.74 (average of R$15,695.76) (updated values). The mean daily cost of hospitalization was R$4,478.64. A positive correlation was found between the length of stay and total cost. No significant difference in cost was observed between the two main types of treated fractures.

Conclusion

Fractures in the elderly are frequent, resulting in significant costs. The longer the hospital stay for treatment, the higher the total cost. No correlation was found between total cost and number of comorbidities, number of medications used, and the comparison between the treatment of transtrochanteric and femoral neck fractures.

Highlights

■ Bone fractures were more frequent in women.

■ The mortality rate among patients was 9.6%.

■ The main trauma mechanism was falling from standing height.

■ The total hospitalization cost ranged from R$2,006.53 to R$106,912.74. The mean daily cost was R$4,478.64.

■ The longer the hospital stay for treatment, the higher the total cost.

Related collections

Most cited references 35

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The psychological impact of quarantine and how to reduce it: rapid review of the evidence

Samantha K. Brooks, Rebecca K Webster, Louise E. Smith … (2022)

Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.

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Article: not found

Frailty consensus: a call to action.

John E Morley, Bruno Vellas, G Abellan van Kan … (2013)

Frailty is a clinical state in which there is an increase in an individual's vulnerability for developing increased dependency and/or mortality when exposed to a stressor. Frailty can occur as the result of a range of diseases and medical conditions. A consensus group consisting of delegates from 6 major international, European, and US societies created 4 major consensus points on a specific form of frailty: physical frailty. 1. Physical frailty is an important medical syndrome. The group defined physical frailty as "a medical syndrome with multiple causes and contributors that is characterized by diminished strength, endurance, and reduced physiologic function that increases an individual's vulnerability for developing increased dependency and/or death." 2. Physical frailty can potentially be prevented or treated with specific modalities, such as exercise, protein-calorie supplementation, vitamin D, and reduction of polypharmacy. 3. Simple, rapid screening tests have been developed and validated, such as the simple FRAIL scale, to allow physicians to objectively recognize frail persons. 4. For the purposes of optimally managing individuals with physical frailty, all persons older than 70 years and all individuals with significant weight loss (>5%) due to chronic disease should be screened for frailty. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

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Osteoporosis in the European Union: medical management, epidemiology and economic burden

E. Hernlund, A Svedbom, M Ivergård … (2013)

Summary This report describes the epidemiology, burden, and treatment of osteoporosis in the 27 countries of the European Union (EU27). Introduction Osteoporosis is characterized by reduced bone mass and disruption of bone architecture, resulting in increased risk of fragility fractures which represent the main clinical consequence of the disease. Fragility fractures are associated with substantial pain and suffering, disability and even death for affected patients and substantial costs to society. The aim of this report was to characterize the burden of osteoporosis in the EU27 in 2010 and beyond. Methods The literature on fracture incidence and costs of fractures in the EU27 was reviewed and incorporated into a model estimating the clinical and economic burden of osteoporotic fractures in 2010. Results Twenty-two million women and 5.5 million men were estimated to have osteoporosis; and 3.5 million new fragility fractures were sustained, comprising 610,000 hip fractures, 520,000 vertebral fractures, 560,000 forearm fractures and 1,800,000 other fractures (i.e. fractures of the pelvis, rib, humerus, tibia, fibula, clavicle, scapula, sternum and other femoral fractures). The economic burden of incident and prior fragility fractures was estimated at € 37 billion. Incident fractures represented 66 % of this cost, long-term fracture care 29 % and pharmacological prevention 5 %. Previous and incident fractures also accounted for 1,180,000 quality-adjusted life years lost during 2010. The costs are expected to increase by 25 % in 2025. The majority of individuals who have sustained an osteoporosis-related fracture or who are at high risk of fracture are untreated and the number of patients on treatment is declining. Conclusions In spite of the high social and economic cost of osteoporosis, a substantial treatment gap and projected increase of the economic burden driven by the aging populations, the use of pharmacological interventions to prevent fractures has decreased in recent years, suggesting that a change in healthcare policy is warranted.

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Author and article information

Contributors

Aline Cremasco Rocha:

ORCID: https://orcid.org/0000-0002-3096-4973

Role: conceptualizationRole: data curationRole: formal analysisRole: investigationRole: methodologyRole: resourcesRole: softwareRole: visualizationRole: and writing - original draft

Bruna Granig Valente:

ORCID: https://orcid.org/0000-0002-3281-9235

Role: conceptualizationRole: data curationRole: investigationRole: softwareRole: and writing-original draft

Danilo Wingeter Ramalho:

ORCID: https://orcid.org/0000-0002-9157-1428

Role: conceptualizationRole: data curationRole: investigationRole: softwareRole: visualizationRole: and writing - original draft

Juliana Baleki Borri:

ORCID: https://orcid.org/0000-0003-2590-6426

Role: conceptualizationRole: data curationRole: investigationRole: softwareRole: visualizationRole: and writing - original draft

Carlos Augusto de Mattos:

ORCID: https://orcid.org/0000-0003-3482-5265

Role: conceptualizationRole: project administrationRole: supervisionRole: validationRole: and writing - review & editing

Cintia Kelly Bittar:

ORCID: https://orcid.org/0000-0002-1997-5372

Role: conceptualizationRole: formal analysisRole: methodologyRole: project administrationRole: softwareRole: supervisionRole: validationRole: and writing-review & editing

Journal

Journal ID (nlm-ta): Einstein (Sao Paulo)

Journal ID (iso-abbrev): Einstein (Sao Paulo)

Journal ID (publisher-id): eins

Title: Einstein

Publisher: Instituto Israelita de Ensino e Pesquisa Albert Einstein

ISSN (Print): 1679-4508

ISSN (Electronic): 2317-6385

Publication date (Electronic): 10 July 2024

Publication date Collection: 2024

Volume: 22

Electronic Location Identifier: eGS0493

Affiliations

[1 ] orgnamePontifícia Universidade Católica de Campinas Campinas SP Brazil original Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil.

[2 ] orgnameHospital PUC-Campinas Celso Pierro Campinas SP Brazil original Hospital PUC-Campinas Celso Pierro, Campinas, SP, Brazil.

Author notes

Corresponding author: Aline Cremasco Rocha. Avenida John Boyd Dunlop, s/n, Jardim Ipaussurama. Zip code: 13034-685 - Campinas, SP, Brazil. Phone: (55 19) 3343-6800. e-mail: alinecremasco@ 123456gmail.com

Associate Editor: Paola Zucchi. Universidade Federal de São Paulo, São Paulo, SP, Brazil. ORCID: https://orcid.org/0000-0002-0672-1584

Conflict of interest: none.

Author information

Aline Cremasco Rocha https://orcid.org/0000-0002-3096-4973

Bruna Granig Valente https://orcid.org/0000-0002-3281-9235

Danilo Wingeter Ramalho https://orcid.org/0000-0002-9157-1428

Juliana Baleki Borri https://orcid.org/0000-0003-2590-6426

Carlos Augusto de Mattos https://orcid.org/0000-0003-3482-5265

Cintia Kelly Bittar https://orcid.org/0000-0002-1997-5372

Article

Other ID: 00302

DOI: 10.31744/einstein_journal/2024GS0493

PMC ID: 11239199

SO-VID: 88637b11-f8e5-4ea5-8822-05ccc26d2d8b

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 20 February 2023

Date accepted : 18 December 2023

Page count

Figures: 2, Tables: 2, Equations: 0, References: 30

Cost and time of hospitalization for elderly people with bone fractures in a reference hospital

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Abstract

In Brief

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Most cited references 35

The psychological impact of quarantine and how to reduce it: rapid review of the evidence

Frailty consensus: a call to action.

Osteoporosis in the European Union: medical management, epidemiology and economic burden

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