Negating the burden of hip fracture in high-risk populations: a narrative review of epidemiology, costs, and multifaceted mitigation strategies

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INTRODUCTION: Hip fractures represent a major global health burden, associated with substantial morbidity, mortality, and economic costs, particularly among older adults. With population aging accelerating worldwide, understanding of the epidemiology, cost drivers, and cost-effectiveness of prevention and management strategies is essential for informed resource allocation. AREAS COVERED: This review summarizes the global burden and costs of hip fractures, with emphasis on high-risk groups. We searched the literature in MEDLINE (via Ovid), ScienceDirect, Scopus, PubMed, and Google Scholar. Data from the 2023 Global Burden of Disease study indicate 24.3 million new hip fracture cases globally. Burden and costs vary widely across regions, influenced by demographic trends, healthcare access, and system capacity. The review evaluates the cost-effectiveness of pharmacologic and non-pharmacologic interventions, along with broader health system approaches aimed at reducing incidence, improving treatment pathways, and preventing secondary fractures. EXPERT OPINION: Reducing the growing burden of hip fractures requires a multifaceted approach. While cost-effective interventions exist, their real-world implementation remains uneven. Future priorities include closing care gaps through systematic models, enhancing medication adherence, and tailoring strategies for low-resource settings. Emerging opportunities, such as digital health tools may improve risk stratification and personalize prevention, supporting more sustainable and equitable hip fracture care globally.

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