Evidence map›Paper›PMID 26286626›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2016

Impact of hip fracture on hospital care costs: a population-based study.

J Leal, A M Gray, D Prieto-Alhambra, N K Arden, C Cooper, M K Javaid, A Judge, REFReSH study group

3 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 198 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
198citing papers in PubMed, 16 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03930992 phase3completednot on this mapstarted 2019, after this paper: background citation

Efficacy of 4 mg Zoledronic Acid Plus Colaren vs 4mg Zoledronic Acid + Conventional Treatment for Secondary Osteoporosis in HIV Positive and Negative Men

TypeinterventionalSponsorUniversity of GuadalajaraRan2019 to 2022Enrolled30ConditionsSecondary OsteoporosisArmsColaren in HIV positive, standard treatment in HIV positive, Colaren in HIV negative, standard treatment in HIV negative
NCT06212622 completednot on this mapstarted 2024, after this paper: background citation

Is the Rate of Early Mobilisation in Hip Fracture Patients Using Alfentanil Better Than Standard Opioid Analgesia (REHAB): a Prospective Cohort Study

TypeobservationalSponsorNHS LothianRan2024 to 2024Enrolled64ConditionsHip Injuries, Hip Fractures, Pain, Post Operative PainArmsAlfentanil, Oxycodone
NCT07027241 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Multicomponent Exercise and Nutrition Based Frailty Intervention in Postoperative Hip Fracture Inpatients

TypeinterventionalSponsorRoyal College of Surgeons, IrelandRan2025 to 2026Enrolled50ConditionsHip Fractures (ICD-10 72.01-72.2), Frailty at Older Adults, Strength Training, Resistance TrainingArmsExercise Intervention, Usual Care, Nutritional Intervention
3 · Its place in the literature

Who cites it

198 citing papers in PubMed, 16 syntheses or guidelines pooled it.

  1. Impact of anti-osteoporosis medication on refracture prevention following osteoporotic vertebral fracture: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Pooled it
  2. Guideline
  3. Effects of pre-operative continuing oral anticoagulants or antiplatelets on health outcomes among older patients with hip fracture: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Pooled it
  4. Pooled it
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  9. Differences in hip fracture care in Europe: a systematic review of recent annual reports of hip fracture registries.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022
    Pooled it
  10. Guideline
  11. Sedentary behaviour and bone health in older adults: a systematic review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021
    Pooled it
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  16. Costs of fragility hip fractures globally: a systematic review and meta-regression analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017
    Pooled it
  17. Trial
  18. Trial
  19. Timeline of functional recovery after hip fracture in seniors aged 65 and older: a prospective observational analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019
    Trial
  20. Article

138 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

J LealHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK. jose.leal@dph.ox.ac.uk.
A M GrayHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK.
D Prieto-AlhambraOxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, OX3 7LD, UK.
N K ArdenOxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, OX3 7LD, UK.
C CooperOxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, OX3 7LD, UK.
M K JavaidOxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, OX3 7LD, UK.
A JudgeOxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, OX3 7LD, UK.
REFReSH study group

Funding

Department of Health 11/1023/01Medical Research Council MC_U147585819Medical Research Council MC_U147585824Medical Research Council MC_U147585827Medical Research Council MC_UP_A620_1014Medical Research Council MC_UU_12011/1
6 · The paper itself

Abstract

unlabelledUsing a large cohort of hip fracture patients, we estimated hospital costs to be £14,163 and £2139 in the first and second year following fracture, respectively. Second hip and non-hip fractures were major cost drivers. There is a strong economic incentive to identify cost-effective approaches for hip fracture prevention.

introductionThe purpose of this study was to estimate hospital costs of hip fracture up to 2 years post-fracture and compare costs before and after the index fracture.

methodsA cohort of patients aged over 60 years admitted with a hip fracture in a UK region between 2003 and 2013 were identified from hospital records and followed until death or administrative censoring. All hospital records were valued using 2012/2013 unit costs, and non-parametric censoring methods were used to adjust for censoring when estimating average annual costs. A generalised linear model examined the main predictors of hospital costs.

resultsA cohort of 33,152 patients with a hip fracture was identified (mean age 83 years (SD 8.2). The mean censor-adjusted 1- and 2-year hospital costs after index hip fracture were £14,163 (95 % confidence interval (CI) £14,008 to £14,317) and £16,302 (95 % CI £16,097 to £16,515), respectively. Index admission accounted for 61 % (£8613; 95 % CI £8565 to £8661) of total 1-year hospital costs which were £10,964 higher compared to the year pre-event (p < 0.001). The main predictors of 1-year hospital costs were second hip fracture, other non-hip fragility fractures requiring hospitalisation and hip fracture-related complications. Total UK annual hospital costs associated with incident hip fractures were estimated at £1.1 billion.

conclusionsHospital costs following hip fracture are high and mostly occur in the first year after the index hip fracture. Experiencing a second hip fracture after the index fracture accounted for much of the increase in costs. There is a strong economic incentive to prioritise research funds towards identifying the best approaches to prevent both index and subsequent hip fractures.

Indexed as

AgedAged, 80 and overCohort StudiesDatabases, FactualFemaleFracture FixationHip FracturesHospital CostsHospitalizationHumansLength of StayMaleOsteoporotic FracturesRecurrenceState MedicineUnited KingdomBurdenCostEpidemiologyHealth economicsHip fractureOsteoporosis

Identifiers

PMID26286626
PMCPMC4740562

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.