Evidence map›Paper›PMID 42069796›Full record

ArticleArchives of orthopaedic and trauma surgery2026

Healthcare utilization following hip fractures based on social vulnerability status in the US: an analysis of 2016-2020 nationwide readmissions data.

Ria Tilve, Guangjin Zhou, Shujaa T Khan, Siran M Koroukian, Matthew Deren, Nicolas S Piuzzi

Abstract read
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Article in Archives of orthopaedic and trauma surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Ria TilveCase Western Reserve University, Cleveland, USA.
Guangjin ZhouDepartment of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, USA.
Shujaa T KhanDepartment of Orthopedic Surgery, Cleveland Clinic, Cleveland, USA.
Siran M KoroukianDepartment of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, USA.
Matthew DerenDepartment of Orthopedic Surgery, Cleveland Clinic, Cleveland, USA.
Nicolas S PiuzziDepartment of Orthopedic Surgery, Cleveland Clinic, Cleveland, USA. piuzzin@ccf.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSocial vulnerability (SV) influences rehabilitation and postoperative care for patients with hip fracture. However, most previous work relies on area-level measures that overlook interindividual variation. The recent adoption of ICD-10 Z-codes allows clinical identification of patient-level SV and may offer a better understanding of its impact. This study aimed to evaluate healthcare utilization, including readmissions, discharge disposition, and length of stay (LOS) in surgically treated hip fracture patients with and without clinically acknowledged SV.

methodsAdults surgically treated for hip fracture between 2016 and 2020 were included from the Nationwide Readmissions Database. SV was defined as having at least one documented relevant ICD-10 Z-code. Primary outcome measures included complications, LOS, discharge disposition, and 30- and 90-day readmissions, stratified by SV and evaluated using chi-square analyses. Multivariable logistic regression assessed long LOS (≥ 5 days) and discharge to home, adjusting for age, insurance/income status, and substance use.

resultsPatients with SV were younger (35.6% with SV vs. 50.1% without SV were 81+), had a lower median household income (38.8% with SV vs. 25.7% without SV were in the lowest quartile), and were more often insured by Medicaid (19.3% vs. 3.8%). Alcohol/drug use disorders were significantly more prevalent in patients with SV (18.5% vs. 4.5%). SV was associated with 47% higher odds for long LOS (1.47, 1.41-1.54) and 23% higher odds for discharge to home (1.23, 1.16-1.30) but comparable 90-day readmissions (21.2% vs. 19.8%).

conclusionAmong surgically treated hip fracture patients, SV was associated with higher odds of long LOS and discharge to home but no meaningful difference in readmissions. The small number of patients with clinically documented SV highlights the limited reporting by healthcare workers. This analysis of a nationwide all-payer database highlights the need to identify these higher risk patients and implement appropriate care pathways to reduce healthcare utilization.

Indexed as

Hip FracturesPatient Acceptance of Health CarePatient ReadmissionSocial VulnerabilityAgedAged, 80 and overDatabases, FactualFemaleHumansLength of StayMaleMiddle AgedPatient DischargeSocioeconomic Disparities in HealthUnited StatesComplicationsHealthcare utilizationHip fractureSocial determinants of health

Identifiers

PMID42069796
PMCPMC13135577

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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.