Burrack, Nitzan; Hatfield, Laura A; Bakx, Pieter; Banerjee, Amitava; Chen, Yu-Chin; Fu, Christina; Godoy Junior, Carlos; ... Landon, Bruce E; + view all Burrack, Nitzan; Hatfield, Laura A; Bakx, Pieter; Banerjee, Amitava; Chen, Yu-Chin; Fu, Christina; Godoy Junior, Carlos; Gordon, Michal; Heine, Renaud; Huang, Nicole; Ko, Dennis T; Lix, Lisa M; Novack, Victor; Pasea, Laura; Qiu, Feng; Stukel, Therese A; Uyl-de Groot, Carin; Ravi, Bheeshma; Al-Azazi, Saeed; Weinreb, Gabe; Cram, Peter; Landon, Bruce E; - view fewer (2023) Variation in care for patients presenting with hip fracture in six high-income countries: A cross-sectional cohort study. Journal of the American Geriatrics Society (AGS) 10.1111/jgs.18530. (In press).

Text Banerjee_Variation in Care for Patients Presenting with Hip Fracture in 6 High-Income Countries- A Cross-Sectional Cohort Study.pdf Access restricted to UCL open access staff until 12 August 2024. Download (197kB)

Abstract

Background: Hip fractures are costly and common in older adults, but there is limited understanding of how treatment patterns and outcomes might differ between countries. // Methods: We performed a retrospective serial cross-sectional cohort study of adults aged ≥66 years hospitalized with hip fracture between 2011 and 2018 in the US, Canada, England, the Netherlands, Taiwan, and Israel using population-representative administrative data. We examined mortality, hip fracture treatment approaches (total hip arthroplasty [THA], hemiarthroplasty [HA], internal fixation [IF], and nonoperative), and health system performance measures, including hospital length of stay (LOS), 30-day readmission rates, and time-to-surgery. // Results: The total number of hip fracture admissions between 2011 and 2018 ranged from 23,941 in Israel to 1,219,696 in the US. In 2018, 30-day mortality varied from 3% (16% at 1 year) in Taiwan to 10% (27%) in the Netherlands. With regards to processes of care, the proportion of hip fractures treated with HA (range 23%–45%) and THA (0.2%–10%) differed widely across countries. For example, in 2018, THA was used to treat approximately 9% of patients in England and Israel but less than 1% in Taiwan. Overall, IF was the most common surgery performed in all countries (40%–60% of patients). IF was used in approximately 60% of patients in the US and Israel, but only 40% in England. In 2018, rates of nonoperative management ranged from 5% of patients in Taiwan to nearly 10% in England. Mean hospital LOS in 2018 ranged from 6.4 days (US) to 18.7 days (England). The 30-day readmission rate in 2018 ranged from 8% (in Canada and the Netherlands) to nearly 18% in England. The mean days to surgery in 2018 ranged from 0.5 days (Israel) to 1.6 days (Canada). // Conclusions: We observed substantial between-country variation in mortality, surgical approaches, and health system performance measures. These findings underscore the need for further research to inform evidence-based surgical approaches.

Download activity - last month

Export as CSVXMLJSON

Download activity - last 12 months

Export as XMLCSVJSON

Downloads by country - last 12 months

Export as JSONCSVXML

Archive Staff Only

View Item