Poster Presentation Annual Meetings of the Endocrine Society of Australia and Society for Reproductive Biology and Australia and New Zealand Bone and Mineral Society 2016

Hospital utilisation, cost and mortality outcomes of hip and non-hip osteoporotic fractures in Western Australia: a ten-year study using linked administrative data (#313)

Wenxing Sun 1 , Andrew Briggs 2 , Laura Miller 1 , Patrick Kelly 3 , William Pyper 4 , Charles Inderjeeth 5
  1. Epidemiology Department, Department of Health WA, Perth, WA, Australia
  2. School of Physiotherapy, Curtin University, Perth, WA, Australia
  3. School of Public Health, University of Sydney, Sydney, NSW, Australia
  4. Health System Economic Modelling, Department of Health, Perth, Western Australia, Australia
  5. North Metropolitan Health and University of Western Australia, Nedlands, WA, Australia

Objectives: To compare hospital utilisation and mortality outcome of non-hip osteoporotic fracture admissions with hip fracture admissions

Methods: Western Australia residents aged ≥ 50 years hospitalised with an index osteoporotic fracture in 2002-2011 were identified and stratified by fracture sites. Readmission due to any subsequent fracture to any hospital and mortality data were linked to the cohort through the WA Data Linkage System.

Results: Of the 974 patients (mean age 82 years, 70% had co-morbidities), two-third sustained an index non-hip fracture. Although hip fractures were more expensive to treat (mean: $40,570 per person), patients with non-hip fractures utilised similar hospital resources (average length of stay ranged from 29-41 days, over 60% required hospital transportation to hospital, 37%-46% readmit to hospital due to re-fracture). The risk of readmission following index spine fracture was 1.5-fold higher (95% CI=1.15-1.99) than following index hip fractures. No significant mortality difference existed between hip and non-hip fracture groups (p=0.59).

Conclusion: Non-hip fractures admissions, occurred in a predominantly older cohort, were associated with comparable hospital resources utilisation to hip fracture admissions in this frail elderly cohort. The risk of readmission and mortality warrants preventive strategies after all fracture presentations.

Implication for public health: This study provided evidence that non-hip fracture in older populations should not be neglected as it identifies cohorts who are frail with higher readmission rates, prolonged hospitalisation and utilisation of health care costs.

  1. Briggs, AM, et al., Hospitalisations, admission costs and re-fracture risk related to osteoporosis in Western Australia are substantial: a 10-year review. Australian and New Zealand Journal of Public Health, 2015. 39(6): p. 557-562.