Hip fractures: changing patterns in hospital bed use in NSW between 1979 and 1990.

Osteoporotic hip fractures are associated with significant medical, social and financial costs. To examine trends in hip fracture incidence, acute hospital admissions, bed use and outcome for these fractures were reviewed for the period 1979-90. In this period, there was a 45% increase in the total number of fractures. In women aged 65 and over increases in admission rate were found between 1979 and 1986. Fracture admission rates for women stabilized after 1986, but remained approximately 7% higher than in the baseline year of 1979. In men aged 65 years and over there was no discernible change in fracture incidence. Length of stay in hospital was inversely related to the total number of proximal femoral fracture cases in each year. As a result of the large decreases in length of stay, overall bed use in 1991 was very similar to that in 1979, in spite of the large increase in fracture admissions. This reduction in length of stay may reflect, not only the pressures of greater demand, but also improved surgical and postoperative management and the effects of early intervention and rapid transit treatments.