Trends in incidence, health care consumption, and medical and productivity costs of femoral shaft fractures in the Netherlands between 2005 and 2019

J Daniël Cnossen; Martien J M Panneman; Suzanne Polinder; Michael H J Verhofstad; Esther M M Van Lieshout

doi:10.1016/j.injury.2023.111140

Trends in incidence, health care consumption, and medical and productivity costs of femoral shaft fractures in the Netherlands between 2005 and 2019

Injury. 2023 Dec;54(12):111140. doi: 10.1016/j.injury.2023.111140. Epub 2023 Oct 16.

Authors

J Daniël Cnossen¹, Martien J M Panneman², Suzanne Polinder³, Michael H J Verhofstad¹, Esther M M Van Lieshout⁴

Affiliations

¹ Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
² Consumer Safety Institute, P.O. Box 75169, 1070, AD, Amsterdam, the Netherlands.
³ Department of Public Health, Erasmus MC, P.O. Box 2040, 3000, CA, Rotterdam, the Netherlands.
⁴ Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. Electronic address: e.vanlieshout@erasmusmc.nl.

PMID: 37865546
DOI: 10.1016/j.injury.2023.111140

Abstract

Introduction: Population-based knowledge on the occurrence of femoral shaft fractures is necessary for allocation of health care services, optimization of preventive measures, and research purposes. This nationwide study aimed to provide an overview on the incidence of femoral shaft fractures over a 15-year period and to gain insight into health care consumption and work absence with associated costs in the Dutch population.

Methods: Data of patients who sustained an acute femoral shaft fracture in the years 2005-2019 were extracted from the National Medical Registration of the Dutch Hospital Database. The incidence rate, hospital length of stay (HLOS), direct medical costs, productivity costs, and years lived with disability were calculated for age- and gender specific groups.

Results: A total of 15,847 patients with a femoral shaft fracture were included. The incidence rate increased with 13 % over this 15-year period (5.71/100,000 persons per year in 2005 and 6.47/100,000 in 2019). The mean HLOS per patient was 13.8 days in 2005-2009 versus 8.4 days in 2015-2019 for the entire group. Mean HLOS per patient increased with age (10.0 days for age group 0-9 and 12.7 days for age group >80), but declined over time from 13.6 days in 2005-2009 to 8.8 days in 2015-2019 in males, and from 13.7 days and to 8.2 days, respectively, in females. The costs due to work absence was higher in males. Cumulative health care costs were highest in females >80 years (8.4 million euros versus 1.6 million in males).

Conclusion: The incidence rate of femoral shaft fractures increased over the past 15 years in the Netherlands. Mean HLOS per patient has decreased in all age groups and in both sexes. Health care costs were highest for female octogenarians.

Keywords: Epidemiology; Femoral shaft fracture; Health care costs; Hospital length of stay; Incidence rate; Productivity costs; Years lived with disability.

MeSH terms

Aged, 80 and over
Female
Femoral Fractures* / epidemiology
Femoral Fractures* / surgery
Femur*
Health Care Costs
Humans
Incidence
Infant, Newborn
Male
Netherlands / epidemiology