Are hip protectors cost effective?
Introduction
Proximal femoral or ‘Hip’ fractures account for over 60,000 annual admissions into orthopaedic wards in England alone and is associated with a significant mortality and morbidity. The injury generally occurs in frail elderly patients as a consequence of a simple fall onto the hip [1]. Hip protectors (Fig. 1) have been devised to absorb the energy of the fall [2]. The purpose of this study is to determine the cost of using hip protectors in terms of the cost/fracture prevented.
Section snippets
Patients and methods
The cost of using hip protectors was obtained from the manufacturer [3]. Estimations for the number of hip protectors used by each person over a year were obtained by correspondence with authors of previous reports on hip protectors [2], [4], [5]. Compliance and estimation of the effectiveness of hip protectors was taken from data within the five randomised trials of hip protectors [4], [5], [6], [7], [8]. These randomised trials were identified by the Cochrane Collaboration Musculoskeletal
Results
The cost of providing hip protectors based on the provision of three pairs/year for all those who complied with wearing the protectors was £113/year. The five randomised trials gave information on the numbers who continued to wear the hip protectors. Summation of results for 694 participants from these studies indicated that overall long-term compliance with wearing the hip protectors occurred in 251 out of 694 trial participants (36%). Therefore, we estimate that it will cost about
Discussion
The average cost of treating a ‘hip’ fracture has been reported to be £7200 (adjusted to 1998 prices) [10]. The results of this study, therefore, indicate that for those aged over 84 years the wearing of hip protectors appears to be cost effective. Financial consequences and calculations take no account of the mortality and morbidity associated with a ‘hip’ fracture that would be avoided. It seems reasonable to conclude from these figures that hip protectors should be routinely provided to all
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