Hip Fracture Is Associated With Major Wealth Loss

Introduction: The annual cost of hip fractures exceeds $6 billion in the United States. Although the direct healthcare costs related to these fractures are known, the full economic impact on individual families is not well studied. Understanding the economic impacts of disease informs policy and interventions. Therefore, we studied the socioeconomic effect of hip fractures on individual household wealth. Methods: Data were sourced from the Health and Retirement Study, a longitudinal panel survey. Individuals who sustained a hip fracture between 2000 and 2016 were identified, and total household wealth was tracked from 2 years before the fracture to 4 years after. Cases were matched with controls using propensity score matching based on age, sex, race, and initial wealth. Wilcoxon rank-sum and Wilcoxon signed-rank tests were used to evaluate wealth changes due to the non-normal data distribution. Results: Median wealth declined by 50% after hip fractures. In contrast, the controls' median wealth remained relatively stable, decreasing by 4.8%. Cases had significantly less wealth after 4 years than controls ( P = 0.025) and compared with their prefracture levels ( P < 0.001). Most wealth loss in cases was due to declines in cash accounts and the value of the primary residence. The middle tertile of initial wealth was most affected, experiencing an approximately 50% decrease. Cases saw decreased stability in permanent housing, and cases without spouses faced an approximately 28% greater decrease in household wealth compared with those with spouses. Conclusion: Hip fractures are associated with substantial household wealth reductions, comparable with the financial burden of major illnesses such as cancer. These findings highlight the enormous value of hip fracture prevention and rapid hip fracture recovery. Lay Summary: Sustaining a hip fracture is associated with losing half of household wealth, comparable with the amount lost by people who have cancer.