Influence of hospital adverse events and previous diagnoses on hospital care cost of patients with hip fracture

• Published in: Archives of osteoporosis 2019-08, Vol.14 (1), p.88-88, Article 88
• Main Authors: Cuesta-Peredo, David, Arteaga-Moreno, Francisco, Belenguer-Varea, Ángel, Llopis-Calatayud, José Emilio, Sivera-Gimeno, Susana, Santaeugenia, Sebastià J., Avellana-Zaragoza, Juan Antonio, Tarazona-Santabalbina, Francisco José
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Anemia - economics; Anemia - etiology; Delirium - economics; Delirium - etiology; Endocrinology; Female; Hip Fractures - complications; Hip Fractures - economics; Hospital Costs - statistics & numerical data; Hospitalization - economics; Hospitals - statistics & numerical data; Humans; Length of Stay - economics; Male; Medicine; Medicine & Public Health; Original Article; Orthopedics; Retrospective Studies
• ISSN: 1862-3522; 1862-3514
• DOI: 10.1007/s11657-019-0638-6

Summary Previous diagnoses of patients with hip fracture influence the hospitalization cost of these patients, either directly or by increasing the risk of in-hospital adverse events associated with increased costs. Purpose To investigate how previous diagnoses influence the occurrence of in-hospital adverse events and how both factors impact on hospital costs. Methods This is a retrospective analysis of the hospital Minimum Basic Data Set. Patients aged 70 years or older admitted for hip fracture (HF) at a single University Hospital between January 2012 and December 2016. Both, previous diagnoses and adverse events, were defined according to the International Classification of Diseases (ICD-9/ICD-10). The anticipated cost of each admission was calculated based on diagnosis-related groups and using the “all patients refined” method (APR-DRG). The occurrence of adverse events during hospital stay was assessed by excluding all diagnoses present on admission. Results The record included 1571 patients with a mean (SD) age of 84 years. The most frequent previous diagnoses were diabetes ( n  = 432, 27.5%) and dementia ( n  = 251, 16.0%), and the most frequent adverse events were delirium ( n  = 238, 15.1%) and anemia ( n  = 188, 12.0%). The mean (SD) total acute care costs per patient were €8752.1 (1864.4). The presence of heart failure, COPD, and kidney disease at admission significantly increased the hospitalization cost. In-hospital adverse events of delirium, cardiac events, anemia, urinary tract infection, and digestive events significantly increased costs. The multivariate analyses identified kidney disease as a previous diagnosis significantly contributing to explain an increase in hospitalization costs, and delirium, cardiac disease, anemia, urinary infection, respiratory event, and respiratory infection as in-hospital adverse events significantly contributing to an increase of hospitalization costs. Conclusions Although few baseline comorbidities have a direct impact on hospitalization costs, most previous diagnoses increase the risk of in-hospital adverse events, which ultimately influence the hospitalization cost.