Ann Rehabil Med.  2018 Aug;42(4):569-574. 10.5535/arm.2018.42.4.569.

Correlation Between Walking Ability and Monthly Care Costs in Elderly Patients After Surgical Treatments for Hip Fractures

• Abe K
• Inage K
• Yamashita
• Yamashita
• Yamamaoka
• Norimoto M
• Nakata Y
• Mitsuka T
• Suseki K
• Orita S
• Fujimoto K
• Shiga Y
• Kanamoto H
• Inoue M
• Kinoshita
• Umimura T
• Eguchi Y
• Furuya T
• Takahashi
• Ohtori S

• KMID: 2420049
• DOI: http://doi.org/10.5535/arm.2018.42.4.569

Abstract

OBJECTIVE
To validate the relationship between residual walking ability and monthly care cost as well as long-term care insurance (LTCI) certification level in elderly patients after surgical treatment for hip fractures in Japan.
METHODS
Elderly patients aged >75 years who underwent surgical treatment for hip fractures in our hospital were included. The preand post-surgical (6-month) walking ability and LTCI certification and the presence or absence of dementia was determined from medical records and questionnaires. Walking ability was classified into 6 levels used in our daily medical practice. Based on these data, we correlated the relationship between walking ability and the LTCI certification level. Further, based on the official statistics pertaining to the average monthly costs per person at each LTCI certification level, we evaluated the relationship between walking ability and monthly care cost.
RESULTS
A total of 105 cases (mean age, 80.2 years; 16 men; 39 patients with dementia) were included. The correlation between walking ability and average monthly cost per person as well as LTCI certification level at 6 months postoperatively (r=0.58) was demonstrated. The correlation was found in both groups with and without dementia.
CONCLUSION
The ability to walk reduced the cost of care in elderly patients who experienced hip fracture, regardless of the presence of dementia.

Keyword

Hip fractures; Dementia; Long-term care; Mobility limitation; Cost-benefit analysis

MeSH Terms

Aged*
Certification
Cost-Benefit Analysis
Dementia
Hip Fractures*
Hip*
Humans
Insurance, Long-Term Care
Japan
Long-Term Care
Male
Medical Records
Mobility Limitation
Walking*

Figure

• 

  Fig. 1. Dot diagram showing the change in walking ability. Walking ability was classified as follows: ability to walk freely (Free), ability to walk with a cane (Cane), ability to walk with a walker (Walker), ability to walk along a bar (Bar), ability to ambulate using a wheelchair (Wheel), inability to walk and/or bedridden (Bed). NS, no significant difference; POM, months postoperatively. *p<0.05.

• 

  Fig. 2. Correlation between walking ability and insurance certification level. NA, not applicable; SL1 and SL2, support levels 1 and 2, respectively; CL1, CL2, CL3, CL4, and CL5, care levels 1 to 5, respectively.

• 

  Fig. 3. Correlation between walking ability and average monthly care costs. The black straight line represents the regression curve.

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