Summary

Hip fractures are breaks occurring at the top of the thigh bone (femur). They place considerable burden on the wellbeing of the individual, their family, and carers, and represent a substantial cost to the health-care system in Australia.

This report provides national data on the incidence and hospital-based treatment of hip fractures in Australia, using data from the National Hospital Morbidity Database for 2015–16.

It complements available subnational and cohort clinical register data, and provides a national baseline for future population monitoring work on hip fracture prevention, risk, incidence, management, and outcomes.

In 2015–16, hip fractures were managed in a total of 50,900 episodes of hospital care, for both new (incident) hip fractures, and management and repair of previous fractures. These hospitalisations equate to more than 579,000 bed days, and involved more than 206,300 procedures or interventions.

Hip fractures are common in Australia, although hospitalisation rates are declining

In 2015–16, there were an estimated 18,700 new hip fractures among Australians aged 45 and over—a crude (age-specific) rate of 199 fractures per 100,000 population.

Of these:

  • 56% were neck-of-femur fractures
  • 38% were pertrochanteric fractures
  • 5.8% were subtrochanteric fractures.

The number of new hip fractures rose over time, in line with population ageing. But after accounting for differences in the age structure of the population over time, the rate of hospitalisations for new hip fractures fell by 9.5% between 2006–07 and 2015–16.

Hip fractures are commonly the result of falls, occur mostly at home, and are associated with other conditions

In 2015–16, of new hip fractures, 93% were the result of a fall-related injury, and 87% were minimal trauma (low-impact) falls.

Nearly half (48%) occurred in the person’s private home, and about one-quarter (27%) occurred in an aged care facility.

Just under 95% of new hip fracture hospitalisations included at least 1 additional diagnosis (comorbid condition). The most commonly recorded conditions were:

  • other disorders of fluid, electrolyte, and acid-base balance (20%)
  • other anaemias (20%)
  • delirium (20%)
  • type 2 diabetes (19%).

Some population groups are at greater risk of hip fractures than others

In 2015–16, the hospitalisation rate for new hip fractures rose substantially with age. When the influence of age was adjusted for, new hip fractures were:

  • 1.7 times as high for women as for men
  • 5% higher for Indigenous Australians than for other Australians.

Some new hip fractures are not treated with surgery

In 2015–16, an estimated 1,200 hip fractures were not surgically managed—a rate of 12 per 100,000 people aged 45 and over.

Compared with other new hip fractures, those that were not surgically treated were:

  • more likely to occur at younger ages
  • more likely to occur in men
  • less likely to be comorbid
  • less likely to be the result of falls
  • more likely to be a pertrochanteric fracture.