Osteoporotic hip fracture costs in the elderly Turkish population

Objective: This study was designed to determine the length of hospital stay and treatment costs of patients with osteoporotic hip fractures in Turkey. Methods: A total of 1,118 osteoporotic hip fractures taken from patient records in 35 hospitals connected to a Disease Related Group (DRG) network were included in the study. Inclusion cri¬teria were patients over the age of fifty with a diagnosis of a single, low-energy fracture located at the neck, head, or intertrochanteric region of the femur treated with total/hemi-arthroplasty, screw or nail methods. We examined the demographics, location of fracture, treatment type, length of hospital stay (LOS), direct cost and cost extrapolation based on the numbers of hospi¬tals, beds and patient by hospital. Results: Of the 1,118 patients (mean age: 75.3±9.9 years), 62.8% were female. The main frac¬ture type was of the femur neck without precise localization. The average LOS was 11.0±7.9 days. The total weighed cost of all 1,118 hip fractures was $2,249,885 per year, indicating an average direct medical cost of $3,119 per patient in the 35 DRG hospitals. Based on this sample, the estimated total number of patients is 15,602 by number of hospitals; 8,521 by number of hos¬pital beds and 9,365 by number of hospitalization, costing $31,530 million; $14,793 million and $18,948 million, respectively. Conclusion: Diverse results in cost estimations of osteoporotic hip fractures reflect the incoher¬ence of data as well as a lack of standardization of health care services. Therefore, ICD and DRG coding needs to be improved and a national database must be created at least for the invoices of importation of prostheses to fully be able to calculate the burden of osteoporosis across Turkey.