COSTS OF HIP FRACTURE - REHABILITATION OF 180 PATIENTS IN PRIMARY HEALTH-CARE

Costs related to functional status were calculated for 180 consecutive hip fracture patients (mean age 78 years) who were admitted from their own home and rehabilitated in primary health care. Within 4 months after the fracture, 75 percent of the patients had been discharged to their own home, 9 percent were dead, and the short-term medical treatment cost per patient were SEK 43,000, whereas the total costs including communal help and costs for living accommodations after discharge were twice as high. The total costs per patients for long-term medical treatment (from 4 months up to 3 years after fracture) were 7 percent of the short-term medical treatment costs. Patients with a cervical fracture discharged to their own home and with good functional status consumed only one fifth of the resources that patients with a trochanteric fracture discharged to institutional care and who had reduced functional status consumed. A substantial part of the costs can be saved by improved organization of rehabilitation after discharge from the hospital. A further cost reduction would require a combination of technologic, social, and organizational changes aimed at early discharge and continued follow-up in primary health care.