Social care following hip fractures costs more than £15,000 per patient every year, according to a new study by Oxford researchers. This amounts to a total cost of £1.25 billion per year.
Hip fracture is the most common serious injury in older adults, affecting over 80,000 people in the UK every year. The loss of mobility, function and independence after a hip fracture means that many people need additional support. This varies between individuals but typically involves a combination of formal paid care, informal care from family and friends, and changes to the home environment.
While the cost of medical care, including hospital admission, surgery and treatment of complications is well reported, the wider economic impact is less well understood. In particular, the cost of social care after discharge from hospital – the true financial cost of treating and rehabilitating people with hip fractures – has been poorly quantified.
This new study by researchers at the University of Oxford’s Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS) provides the most comprehensive evidence to date that social care represents a major, and often hidden, component of the overall burden of hip fracture. The research was supported by the National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre (BRC).
The study, published in Age & Ageing, aimed to examine the use and cost of social care after hip fracture and to assess how these costs differ for patients who developed complications following surgery.
Using data from the Oxford BRC-supported World Hip Trauma Evaluation (WHiTE) study, 16,679 patients aged 60 years and over, who underwent surgery for hip fracture were followed for four months.
Social care use during the first four months after injury was compared with patients’ care needs before their fracture. Social care costs included changes in residential status (such as moving into residential or nursing care), formal home care, informal care from family or friends, and home adaptations.
The average cost of social care after hip fracture was £15,525 per person. The largest share of this cost came from formal and informal home care, accounting for £12,849 per person. Changes in residential care requirements contributed a further £1,656 per person, while home adaptations added £1,021 per person.
When projected to the UK hip fracture population, the total cost of social care in the first four months after the injury was estimated at £1.25 billion.
This study also showed that complications following hip fracture further increase social care costs. Patients who developed surgery-specific complications incurred an additional £1,264 in social care costs, while those who developed general complications incurred an additional £1,418. Much of this increase was driven by greater need for home care and, to a lesser extent, changes in residential status and additional home adaptations. These costs accrue after discharge and are not captured in existing data sources.
Lead author En Lin Goh (pictured left), post-doctoral researcher at NDORMS, said: “Much of the cost of hip fracture is hidden from view. After leaving hospital, many patients rely heavily on social care and support from family and friends, and those costs are just as important, and far more substantial than many people realise.
“They rival the costs of medical care, highlighting why health and social care services need to be planned together if we are to support recovery and use resources effectively.”