Mafirakureva, N. orcid.org/0000-0001-9775-6581, Paruk, F. orcid.org/0000-0002-2710-899X, Cassim, B. orcid.org/0000-0002-0859-868X et al. (3 more authors) (2023) The healthcare system costs of hip fracture care in South Africa. Osteoporosis International, 34 (4). pp. 803-813. ISSN 0937-941X
Abstract
Summary
Despite rapidly ageing populations, data on healthcare costs associated with hip fracture in Sub-Saharan Africa are limited. We estimated high direct medical costs for managing hip fracture within the public healthcare system in SA. These findings should support policy decisions on budgeting and planning of hip fracture services.
Purpose We estimated direct healthcare costs of hip fracture (HF) management in the South African (SA) public healthcare system.
Methods
We conducted a micro-costing study to estimate costs per patient treated for HF in five regional public sector hospitals in KwaZulu-Natal (KZN), SA. Two hundred consecutive, consenting patients presenting with a fragility HF were prospectively enrolled. Resources used including staff time, consumables, laboratory investigations, radiographs, operating theatre time, surgical implants, medicines, and inpatient days were collected from presentation to discharge. Counts of resources used were multiplied by unit costs, estimated from the KZN Department of Health hospital fees manual 2019/2020, in local currency (South African Rand, ZAR), and converted to 2020 US$ prices. Generalized linear models estimated total covariate-adjusted costs and cost predictors.
Results
The mean unadjusted cost for HF management was US$6935 (95% CI; US$6401–7620) [ZAR114,179 (95% CI; ZAR105,468–125,335)]. The major cost driver was orthopaedics/surgical ward costs US$5904 (95% CI; 5408–6535), contributing to 85% of total cost. The covariate-adjusted cost for HF management was US$6922 (95% CI; US$6743–7118) [ZAR113,976 (95% CI; ZAR111,031–117,197)]. After covariate adjustment, total costs were higher in patients operated under general anaesthesia [US$7251 (95% CI; US$6506–7901)] compared to surgery under spinal anaesthesia US$6880 (95% CI; US$6685–7092) and no surgery US$7032 (95% CI; US$6454–7651).
Conclusion
Healthcare costs following a HF are high relative to the gross domestic product per capita and per capita spending on health in SA. As the population ages, this significant economic burden to the health system will increase.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2023 International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation. This is an author-produced version of a paper subsequently published in Osteoporosis International. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Costs; Economic burden; Health economics; Hip fracture; Osteoporosis; South Africa; Humans; South Africa; Delivery of Health Care; Health Care Costs; Hip Fractures |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health |
Funding Information: | Funder Grant number WELLCOME TRUST (THE) 217135/Z/19/Z |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 24 May 2024 08:45 |
Last Modified: | 25 May 2024 20:32 |
Status: | Published |
Publisher: | Springer Science and Business Media LLC |
Refereed: | Yes |
Identification Number: | 10.1007/s00198-022-06664-9 |
Related URLs: | |
Sustainable Development Goals: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:212764 |