ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2023
The healthcare system costs of hip fracture care in South Africa.
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, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Epidemiology, patient outcome and complications after non-operative management of hip fracture: a systematic review.Anaesthesia · 2025Pooled it
- Health economic evaluation of hip fracture care pathways in The Gambia.BMJ global health · 2026Article
- Age- and sex-specific incidence rates and future projections for hip fractures in The Gambia, West Africa, and comparison across four countries in Africa.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2026Article
- Hip fracture care in Africa: Time for action.PLOS global public health · 2026Article
- Hip fracture care in Zimbabwe : a cohort-based health economic analysis.Bone & joint open · 2025Article
- Does Preoperative CT Improve Outcomes in Femoral Neck Fracture Fixation? A Retrospective Study.Journal of clinical medicine · 2025Article
- Challenges to fracture service availability and readiness provided by allopathic and traditional health providers: national surveys across The Gambia and Zimbabwe.Journal of global health · 2025Article
- The incidence, prevalence, and health burden of hip fractures in China: Data from the global burden of disease study 2019.Preventive medicine reports · 2024Article
- Fractures in sub-Saharan Africa: epidemiology, economic impact and ethnography (Fractures-EWellcome open research · 2023Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
Despite rapidly ageing populations, data on healthcare costs associated with hip fracture in Sub-Saharan Africa are limited. We estimated high direct medical costs for managing hip fracture within the public healthcare system in SA. These findings should support policy decisions on budgeting and planning of hip fracture services. PURPOSE: We estimated direct healthcare costs of hip fracture (HF) management in the South African (SA) public healthcare system.
methodsWe conducted a micro-costing study to estimate costs per patient treated for HF in five regional public sector hospitals in KwaZulu-Natal (KZN), SA. Two hundred consecutive, consenting patients presenting with a fragility HF were prospectively enrolled. Resources used including staff time, consumables, laboratory investigations, radiographs, operating theatre time, surgical implants, medicines, and inpatient days were collected from presentation to discharge. Counts of resources used were multiplied by unit costs, estimated from the KZN Department of Health hospital fees manual 2019/2020, in local currency (South African Rand, ZAR), and converted to 2020 US$ prices. Generalized linear models estimated total covariate-adjusted costs and cost predictors.
resultsThe mean unadjusted cost for HF management was US$6935 (95% CI; US$6401-7620) [ZAR114,179 (95% CI; ZAR105,468-125,335)]. The major cost driver was orthopaedics/surgical ward costs US$5904 (95% CI; 5408-6535), contributing to 85% of total cost. The covariate-adjusted cost for HF management was US$6922 (95% CI; US$6743-7118) [ZAR113,976 (95% CI; ZAR111,031-117,197)]. After covariate adjustment, total costs were higher in patients operated under general anaesthesia [US$7251 (95% CI; US$6506-7901)] compared to surgery under spinal anaesthesia US$6880 (95% CI; US$6685-7092) and no surgery US$7032 (95% CI; US$6454-7651).
conclusionHealthcare costs following a HF are high relative to the gross domestic product per capita and per capita spending on health in SA. As the population ages, this significant economic burden to the health system will increase.
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