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2021, Number 4

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Ortho-tips 2021; 17 (4)

Costs of surgical delay in fragility hip fracture

Viveros-García JC, Rodríguez-Sánchez B, Baldenebro-Lugo LS, Guillermo-Nuncio EA, Nieto-Sandoval HR, Vázquez-Cantero E

Language: Spanish
References: 31
Page: 195-201
PDF size: 182.68 Kb.


ABSTRACT

Introduction: Hip fracture has a high rate of complications, mortality and increases the risk of developing functional decline. In addition to this, the costs are very high. There are modifiable factors such as surgical delay that unnecessarily raise health costs. Decreasing surgical delay can reduce costs and improve healthcare outcomes. Objectives: To analyze the costs generated by the surgical delay in hip fracture and compare them with early surgery. Material and methods: Observational, retrospective, cross sectional study at Hospital Regional ISSSTE León between 2017 to 2018. An analysis of direct costs attributed to the hip bill was carried out in patients with surgery in less than 48 hours and it was compared against surgery in more than 48 hours. Results: The total cost of the hip fracture was $ 124,956 Mexican pesos, with a statistically significant difference of $ 25,539.10 between the group with surgical delay vs early surgery. Conclusion: The surgical delay in hip fracture generates an unnecessary cost to the institute in addition to having negative effects on the health of the patients. Policies must be generated to operate on patients in the first 48 hours.


REFERENCES

  1. Organización Mundial de la Salud. Informe mundial sobre envejecimiento y salud. Luxemburgo: OMS; 2015. [Último acceso 02 junio 2021] Disponible en: https://www.who.int/ageing/publications/world-report-2015/es/

  2. Instituto Nacional de Estadística Geografía e Informática (INEGI). Censo Instituto Nacional de Estadística Geografía e Informática. Porcentaje de hombres de 60 y más años. 2019. [Último acceso 02 junio 2021] Disponible en: https://www.inegi.org.mx/app/buscador/default.html?q=poblacion+mayo+de+60+an?os#tabMCcollap se-Indicadores

  3. International Osteoporosis Foundation. The Latin American Regional Audit. Epidemiología, costos e impacto de la osteoporosis en 2012. 2012. [Ultimo acceso 02 junio 2021] Disponible en: https://www.osteoporosis.foundation/sites/iofbonehealth/files/201906/2012_Latin_America_Audit_Espanol.pdf

  4. Intervenciones de enfermería para la atención de adultos mayores con fractura de cadera. Guía de Evidencias y Recomendaciones: Guía de Práctica Clínica. México: Instituto Mexicano del Seguro Social; 2018. [Último acceso junio 2021] Disponible en: https://www.imss.gob.mx/sites/all/statics/guiasclinicas/603GER.pdf

  5. Guzon-Illescas O, Perez Fernandez E, Crespí Villarias N, Quirós Donate FJ, Peña M, Alonso-Blas C, et al. Mortality after osteoporotic hip fracture: incidence, trends, and associated factors. J Orthop Surg Res. 2019; 14 (1): 203.

  6. Veronese N, Maggi S. Epidemiology and social costs of hip fracture. Injury. 2018; 49 (8): 1458-1460.

  7. Edelmuth SVCL, Sorio GN, Sprovieri FAA, Gali JC, Peron SF. Comorbidities, clinical intercurrences, and factors associated with mortality in elderly patients admitted for a hip fracture. Rev Bras Ortop. 2018; 53 (5): 543-551.

  8. Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM, et al. Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int. 2011; 22 (5): 1277-1288.

  9. International Osteoporosis Foundation. Epidemiology of fragility fractures. [Ultimo acceso 02 junio 2021] Available in: https://www.osteoporosis.foundation/facts-statistics/epidemiology-of-osteoporosis-and-fragility-fractures

  10. Klestil T, Roder C, Stotter C, Winkler B, Nehrer S, Lutz M, et al. Impact of timing of surgery in elderly hip fracture patients: a systematic review and meta-analysis. Sci Rep. 2018; 8 (1): 13933.

  11. Anthony CA, Duchman KR, Bedard NA, Gholson JJ, Gao Y, Pugely AJ, et al. Hip fractures: appropriate timing to operative intervention. J Arthroplasty. 2017; 32 (11): 3314-3318.

  12. Viveros-García JC, Robles-Almaguer E, Arechiga Muñoz E, López Cervantes RE, Torres-Naranjo JF, Baldenebro-Lugo LS. Mexican hip fracture audit (ReMexFC): pilot phase report. J Lat Am Geriatric Med. 2020; 6 (1): 1-9.

  13. Chang W, Lv H, Feng C, Yuwen P, Wei N, Chen W, et al. Preventable risk factors of mortality after hip fracture surgery: systematic review and meta-analysis. Int J Surg. 2018; 52: 320-328.

  14. Villalon-Coca J, Romero-García E, Leira S, Cerda-Palau A, Rollan-García P. La estancia prequirúrgica en la fractura de cadera: la perspectiva del gasto. Gest y Eval Costos Sanit. 2016; 17 (2): 121-131.

  15. Farrow L, Hall A, Wood AD, Smith R, James K, Holt G, et al. Quality of care in hip fracture patients: the relationship between adherence to national standards and improved outcomes. J Bone Joint Surg Am. 2018; 100 (9): 751-757.

  16. Freeman C, Todd C, Camilleri-Ferrante C, Laxton C, Murrell P, Palmer CR, et al. Quality improvement for patients with hip fracture: experience from a multi-site audit. Qual Saf Health Care. 2002; 11 (3): 239-245.

  17. National Institute for Health and Care Excellence (NICE). Hip fracture management guidelines. 2011 updated 2017. [Ultimo acceso 04 junio 2021] Disponible en: https://www.nice.org.uk/guidance/cg124/resources/hip-fracture-management-pdf-35109449902789

  18. Candelario Martínez LJ, López Esqueda FJ, González González GR, González Rubio MV, García Aguirre N, Shiguetomi Medina JM. Associated factors to surgical delay hip fracture in a Mexican hospital. J Lat Am Geriatric Med. 2019; 5 (2): 33-38.

  19. Quevedo-Tejero EC, Zavala-Gonzalez MA, Hernández-Gamas AC, Hernández-Ortega HM. Hip fracture in older adults: prevalence and costs in two hospitals. Tabasco, Mexico, 2009. Rev Peru Med Exp Salud Publica. 2011; 28 (3): 440-445.

  20. Carlos F, Clark P, Maciel H, Tamayo JA. Direct costs of osteoporosis and hip fracture: an analysis for the Mexican Social Insurance Health Care System. Salud Publica Mex. 2009; 51 Suppl 1: S108-S113.

  21. Clark P, Carlos F, Barrera C, Guzman J, Maetzel A, Lavielle P, et al. Direct costs of osteoporosis and hip fracture: an analysis for the Mexican healthcare system. Osteoporos Int. 2008; 19 (3): 269-276.

  22. Clark P, Carlos F, Vázquez Martínez JL. Epidemiology, costs and burden of osteoporosis in Mexico. Arch Osteoporos. 2010; 5 (1-2): 9-17.

  23. Villareal-Rios E, Mathew-Quiroz A, Garza-Elizondo ME, Nuñez-Rocha G, Salinas-Martinez AM, Gallegos-Handal G. Costo de la atención a la hipertensión arterial y su impacto en el presupuesto destinado en saludo en México. Salud Pública Mex. 2002; 44: 7-13.

  24. Macías-Sánchez A, Villareal-Paez HJ. Sostenibilidad del gasto público: Cobertura y financiamiento de enfermedades crónicas en México. Ensayos Revista de Economía. 2018; 37 (1): 99-134.

  25. Granados-García V, Sánchez-García S, Ramírez-Aldana R, Zúñiga-Trejo C, Espinel-Bermúdez CE. Costos por hospitalización de adultos mayores en un hospital regional del IMSS. Rev Med Inst Mex Seguro Soc. 2018; 56 (1): S64-S70.

  26. Franco K, Litaker D, Locala J, Bronson D. The cost of delirium in the surgical patient. Psychosomatics. 2001; 42 (1): 68-73.

  27. Arreguin-Nava R, González-González R, De la Torre-Rosas A. Infecciones adquiridas en los hospitales. ¿Cuánto cuestan y como se calcula? Rev Digit Univ. 2012; 13 (9): 1-10.

  28. Soldevilla Agreda JJ, Torra I Bou JE, Posnett J, Verdu Soriano J, San Miguel L, Mayan Santos M. The burden of pressure ulcers in Spain. Wounds. 2007; 19 (7): 201-206.

  29. Shabat S, Heller E, Mann G, Gepstein R, Fredman B, Nyska M. Economic consequences of operative delay for hip fractures in a non-profit institution. Orthopedics. 2003; 26 (12): 1197-1199; discussion 1199.

  30. Castelli A, Daidone S, Jacobs R, Kasteridis P, Street AD. The determinants of costs and length of stay for hip fracture patients. PLoS ONE. 2015; 10 (7): e0133545.

  31. Pincus D, Wasserstein D, Ravi B, Huang A, Paterson M, Jenkinson R, et al. Medical costs of delayed hip fracture surgery. J Bone Joint Surg Am. 2018; 100: 1387-1396.




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