Hospitalization for the treatment of hip fracture and related procedures, including hip replacement surgery, is increasingly common in older patients, but few studies have examined the associated costs. Researchers used data on 523 patients at one hospital who were admitted for hip fracture and related procedures to identify variables in the cost of hospital care. All of the patients were at least 60 years of age, and most were white, female, and retired.

The mean total hospital cost was more than $17,000, and the median length of stay was 6.26 days. Compared with that on hospital units with the lowest levels of RN staffing, the mean total hospital cost on units with the highest RN-to-patient ratios was more than $1,500 less. And for every 20% decrease in staffing below the unit average, the mean hospital cost increased by almost $1,800. Nurses' management of fluids lowered the hospital cost by helping to prevent complications such as congestive heart failure and pneumonia and by hastening recovery. Other nursing interventions, such as caring for drainage tubes, increased the hospital costs, but the increases were incrementally smaller as the frequency with which they were performed rose. According to the authors, these findings indicate that higher RN-to-patient ratios decrease total hospital cost for patients admitted for the treatment of hip fracture and related procedures because nurses are better able to promptly recognize or prevent complications.