Figure 1.

Model structure and allowed transitions in the first year of simulation. The model simulated the transition of a cohort of patients with an index hip fracture through the health states over time, to estimate expected costs and outcomes. At the start of the simulation, patients with a hip fracture could die within 30 days or be discharged home or to a care home (nursing or residential care home). In the same cycle, patients could then develop a second hip fracture, other major fragility fracture requiring hospitalisation (non-hip such as pelvic, spine, wrist, humerus and rib), have no further events or die. If patients experienced a second hip fracture, they could die within 30 days or, if alive, be discharged to a care home or their own home.