Effect of hospital-acquired complications on hospital length of stay and cost for older adults after a hip fracture in New South Wales, Australia.

Authors

Seigo Mitsutake, Reidar P Lystad, Tolesa Okuba, Janet C Long, Jeffrey Braithwaite, Takumi Hirata, Rebecca Mitchell

Published in

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. Jun 16, 2025. Epub Jun 16, 2025.

Abstract

For older adults following a hip fracture who had hospital-acquired complications (HACs), hospital length of stay (LOS) and costs were over 40% higher compared to those without HACs. Improving strategies for preventing HACs among older adults after a hip fracture would contribute towards a sustainable healthcare system for an aged society.
Although HACs can result in a high financial burden for health systems, little is known about the effect of common HACs on hospital LOS and cost among older adults after a hip fracture. This study examined the effect of HACs on hospital LOS and cost among older adults after a hip fracture.
This retrospective cohort study used linked hospitalisation and mortality data in New South Wales, Australia, between 2013 and 2022. Older adults who were admitted after a hip fracture and discharged between July 2014 and June 2022 were identified. A 1:1 matched design was used to determine hospital LOS and care costs between older patients with and without HACs.
Among 41,013 older patients hospitalised after a hip fracture, 14,050 (34.3%) experienced a HAC. The most common complication was healthcare-associated infections (43.1%). After matching, patients with HACs had a longer hospital LOS (median 31 days, IQR 17-47 days) compared to patients without HACs (median 22 days, IQR 9-35 days) (P < 0.001). Patients with HACs had higher hospital costs (median $84,779, IQR $44,296-$131,426) than patients without HACs (median $60,137, IQR $23,995-$100,300) (P < 0.001). For patients with HACs, hospital LOS was 43% longer (95% confidence interval (CI): 1.41-1.46), and hospital costs were 42% higher (95% CI: 0.40-0.44) compared to those without HACs.
Implementing strategies for preventing HACs among older adults after a hip fracture would contribute towards a sustainable healthcare system as HACs are potentially preventable.

PMID:
40522397
Bibliographic data and abstract were imported from PubMed on 16 Jun 2025.

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