Incidence of hip fracture in New South Wales: are our efforts having an effect?

Objective: To examine trends in hospital admission for hip fracture in New South Wales between July 1990 and June 2000. Design: Analysis of routinely collected hospital separation data. Setting: Public and private acute-care hospitals in NSW. Participants: Admissions of patients aged 50 years and over with a primary diagnosis of fracture of the neck of femur (International classification of diseases, 9th revision [ICD-9] code 820 or ICD-10 codes S72.0-S72.2). Main outcome measures: Number and rates of hospital admission for fracture of the neck of femur per 1000 population; inpatient mortality rates per 1000 admissions. Results: Between July 1990 and June 2000, the number of admissions to NSW acute-care hospitals for hip fracture increased by 41.9% in men (from 1059 to 1503 per year) and by 31.2% in women (from 3160 to 4145 per year). However, age-specific and age-adjusted rates remained practically unchanged. The average length of stay for admissions for hip fracture decreased significantly from 19.2 days (95% Cl, 18.5-19.8 days) in 1990-1991 to 14.2 days (95% Cl, 13.8-14.6 days) in 1999-2000. No significant change was observed in the overall inpatient death rates per 1000 admissions. Conclusions: The findings support recent reports that the increase in hip fracture rates during most of the past century may have ended. However, the number of admissions for hip fracture is still rising. Preventive measures to reduce the burden of this condition on the healthcare system and community need to be pursued and strengthened.