Hip Fracture Outcomes Dependent on Admission Day of the Week and Payer Source

Abstract

Research Question: Is there a correlation between the hospital length of stay for hip fractures and the day of the week of admission or the source of payer?

Background and Significance: Hip fractures pose a unique challenge due to the prevalence of pre-existing medical comorbidities and cognitive impairments among the geriatric population. Hip fractures also cause substantial financial burden on the healthcare system with an estimated annual cost exceedingly over 12 billion dollars. A significant contributing factor to these costs is prolonged hospitalizations, leading to longer lengths of stay and lower hospital reimbursements. We set to investigate whether the day of the week admission or payer source (Managed Medicaid vs Traditional Medicaid) impacted lengths of stays.

Materials and Methods: A geriatric hip fracture database was constructed using patients aged at least 60 years old sustaining a hip fracture between January 1st, 2012, and December 31st, 2020, identified from Texas Harris Fort Worth. Data was analyzed using an analysis of variance (ANOVA), chi-squared test and t-test over SPSS.

Results: Data showed a significant difference in the length of stay across the week, with a p-value of 0.04. There was no significant difference in the incidences of mortality, 30-day mortality, and one-year mortality when compared across the days of the week of admission. A comparison of Managed Medicare / Medicare Advantage with traditional Medicare showed statistically significant (p-value <0.05) longer length of stay on Thursdays for patients enrolled in Managed Medicare / Medicare Advantage

Conclusion: The day of the week admission and payer source has a significant impact on the length of stay for geriatric hip fracture repairs may be attributable to limited weekend resources and increased burdens of coordination.