The impact and consequences of hip fracture in Ontario

Objectives — To assess the magnitude and the burden of hip fracture on the healthcare system, including time trends in hip fracture rates, in-hospital death rates, length of hospital stay (LHS) and discharge destination.

Design — A retrospective study of discharge abstracts.

Setting — The province of Ontario.

Patients — All patients (n = 93,660) over the age of 50 years and with a diagnosis of hip fracture discharged from hospital between 1981 and 1992 (excluding transfers).

Main Outcome Measures — Age-sex standardized hip fracture rates per 1000 population, in-hospital death rates and age-adjusted mean LHS.

Results — The overall hip fracture rate was 3.3 per 1000 persons (1.7 per 1000 men and 4.6 per 1000 women). There was no change in rates between 1981 and 1992 (p = 0.089), but there have been increases in the numbers of hip fractures. There was no change in the in-hospital death rate over time (p = 0.78). The age-adjusted mean LHS in 1981 was 28.6 days compared with 22.2 days in 1992. The numbers of hip fractures will increase from 8490 in 1990 to 16 963 in 2010.

Conclusions — Despite stable age-adjusted rates of hip fractures, the doubling of the number of hip fractures by the year 2010 due to an aging population will become an increasing burden on the healthcare system.