Analysis of demographic, social and economic impacts of proximal femur fracture's surgical treatment for geriatric patients in Russia

Objective. Evaluation of influence on mortality, life expectancy and related costs in the Russian Federation of methodical changes in the organizing surgical treatment of proximal femur fracture (PFF). Material and methods. The mathematical modeling methods were applied for evaluation of impacts, related to methodical changes in the organizing surgical treatment of PFF, including the calculation of life expectancy. It is assumed, that 95% of all patients over 60 years old with PFF would receive a surgical treatment. Calculations were perform in 3 stages: calculation of death causes, related to PFF, calculation of life expectancy change in population and calculation of direct and indirect medical and non-medical costs and social assistance for patients with PFF. Results. Mortality rate from PFF in model is decreased by 51%, which is equal to 55 648 saved lives. Life expectancy indicator increases by 0.3 annually during the transition to new methods of surgical treatment for the patients with PFF. Number of disabled patients is decreasing by 74 179 people annually. Taking into account all the effects, revealed in the modeling, the financial savings are estimated at 12.3 billion rubles or 32% of current expenditures from all funding sources on treatment and social assistance of patients with PFF. Conclusion. Implementation of this new approach to surgical treatment of patients over 60 years old with PFF shows a positive influence on dynamic of demographical indicators of population in general. Despite changes in structure of expenses and increase direct medical costs, new approach in surgical care will lead to a major cost reduction as well as significant improvement of treatment results for geriatric patients with PFF.