Geriatrics & gerontology international · 2025
Impact of Comorbidities on Healthcare and Long-Term Care Costs After Hip Fracture: Analyses of Healthcare and Long-Term Care Insurance Data in Sendai City, Japan.
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Nakatoh Shinichi, Fujimori Kenji, Ishii Shigeyuki, Tamaki Junko, Okimoto Nobukazu, Ogawa Sumito, Iki Masayuki
Аннотация
INTRODUCTION: This pilot study aimed to examine the impact of comorbidities on healthcare and long-term care costs following hip fracture.
METHODS: This retrospective cohort study utilized electronic medical receipt data from the National Health Insurance and the medical care system for older individuals (aged ≥ 75 years) in Sendai City, collected between April 2019 and March 2023. The study included female patients aged ≥ 65 years who were newly registered as hip fracture patients (n = 1346). The total healthcare and long-term care costs incurred from 12 to 7 months before and 7 to 12 months after fracture were analyzed in groups stratified by comorbidities: dementia, cerebral vascular disease (CVD), and osteoarthrosis (OA).
RESULTS: The total healthcare costs remained largely unchanged between the pre- and post-fracture periods across all groups, except in the no-comorbidity and dementia + CVD + OA groups. In the no-comorbidity group, costs significantly increased (p < 0.05), whereas in the dementia + CVD + OA group, they significantly decreased (p < 0.05). In contrast, long-term care costs significantly increased in all groups. Significant differences in long-term care costs were observed among groups (p < 0.05). Additionally, the presence of dementia was associated with significantly higher long-term care costs 7-12 months after hip fracture (p < 0.001).
CONCLUSIONS: This pilot study involving a small patient group indicated the number and type of comorbidities had a minor effect on healthcare costs. However, the presence of dementia significantly increased long-term care costs following hip fracture.
METHODS: This retrospective cohort study utilized electronic medical receipt data from the National Health Insurance and the medical care system for older individuals (aged ≥ 75 years) in Sendai City, collected between April 2019 and March 2023. The study included female patients aged ≥ 65 years who were newly registered as hip fracture patients (n = 1346). The total healthcare and long-term care costs incurred from 12 to 7 months before and 7 to 12 months after fracture were analyzed in groups stratified by comorbidities: dementia, cerebral vascular disease (CVD), and osteoarthrosis (OA).
RESULTS: The total healthcare costs remained largely unchanged between the pre- and post-fracture periods across all groups, except in the no-comorbidity and dementia + CVD + OA groups. In the no-comorbidity group, costs significantly increased (p < 0.05), whereas in the dementia + CVD + OA group, they significantly decreased (p < 0.05). In contrast, long-term care costs significantly increased in all groups. Significant differences in long-term care costs were observed among groups (p < 0.05). Additionally, the presence of dementia was associated with significantly higher long-term care costs 7-12 months after hip fracture (p < 0.001).
CONCLUSIONS: This pilot study involving a small patient group indicated the number and type of comorbidities had a minor effect on healthcare costs. However, the presence of dementia significantly increased long-term care costs following hip fracture.