Trends in incidence, health care use and costs for subtrochanteric femur fractures in the Netherlands 2000–2019

ElsevierVolume 55, Issue 4, April 2024, 111461InjuryAuthor links open overlay panel, , , , , Highlights•

The incidence rates and hospital length-of-stay of subtrochanteric fractures have decreased in the 2000–2019 period in the Netherlands.

Subtrochanteric fracture incidence is higher in women and increases with age.

Subtrochanteric fractures make up a relatively small portion of total hip fractures with an associated annual cost of €15.5 M.

Increasing incidence rates and a bimodal age-distribution, described in previous research, were not found in the Dutch population.

AbstractObjective

This study aimed to provide population based trends in incidence rate, hospital length of stay (HLOS), trauma mechanism, and costs for healthcare and lost productivity of subtrochanteric femur fractures in the Netherlands.

Methods

Data on patients with subtrochanteric femur fractures sustained between January 1, 2000 and December 31, 2019 were extracted from the National Medical Registration of the Dutch Hospital Database. Incidence rates, HLOS, health care and productivity costs were calculated in sex- and age-specific groups.

Results

A total of 14,399 patients sustained a subtrochanteric fracture in the 20-year study period. Incidence rates in the entire population dropped by 15.5 % from 4.5 to 3.8 per 100,000 person years (py). This decline was larger in women (6.4 to 5.2 per 100,000 py, -19.8 %) than in men (2.6 to 2.5 per 100,000 py, -4.0 %). HLOS declined by 62.5 % from a mean of 21.6 days in 2000–2004 to 8.1 days in 2015–2019. Subtrochanteric fractures were associated with total annual costs of €15.5 M, of which 91 % (€14.1 M) were health care costs and €1.3 M were costs due to lost productivity. Mean healthcare costs per case were lower in men (€16,394) than in women (€23,154).

Conclusion

The incidence rates and HLOS of subtrochanteric fractures in the Netherlands have decreased in the 2000–2019 study period and subtrochanteric fractures are associated with a relatively small total annual cost of €15.5 M. Increasing incidence rates and a bimodal age distribution, described in previous studies from other European countries, were not found in the Dutch population.

Keywords

Subtrochanteric fracture

Incidence

Hlos

Health care costs

Lost productivity

Data availability

The data supporting the findings of this study are available on reasonable request from the corresponding author. All data used in figures can be found in Online Resource 1.

© 2024 The Author(s). Published by Elsevier Ltd.

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