Incidence and Barriers to Bone Health Specialist Appointments Following Geriatric Hip Fracture

Purpose The primary aim of this study was to evaluate both the rates and clinical factors associated with bone health (BH) referrals and the subsequent completion of BH evaluations in elderly patients following hip fractures. Methods A retrospective chart review at a single-center Midwest Academic Level 1 Trauma Center was conducted searching for elderly patients (>65 years) experiencing a hip fracture between January 1, 2019, and December 1, 2022, who survived their inpatient stay. Results 578 patients met inclusion criteria, and 304 patients (52.5%) were referred for BH evaluation. Female patients (p=0.044), patients who underwent operative fixation (ORIF) instead of total hip arthroplasty (p=.033), patients with higher calcium values (p=.008) and patients with a shorter length of stay (LOS) (p=.011) were more likely to be referred to BH. Marital status, age, mental health history, tobacco use, vitamin D values, and insurance status were not different between groups. For the 304 patients referred to BH, 183 (60.2%) successfully attended their initial BH evaluation. Younger age (p=.003) and shorter hospital stay (p=0.031) were the only factors significantly associated with visit attendance. Conclusion Shorter LOS, higher calcium values, female sex , and ORIF patients were significantly more likely to be referred for BH evaluation following hip fracture. These findings highlight disparities in referrals, as every included patient met guidelines for bone mineral density screening. Future research should focus on improving referral rates and addressing barriers to attendance, particularly for older patients and those with extended hospital stays.