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Meeting Management Standards and Improvement in Clinical Outcomes Among Patients With Hip Fractures

Trinh, Lieu Thi Thuy; Achat, Helen; Loh, Sze Ming; Pascoe, Robert; Asarreh, Hassan; Stubbs, Joanne

doi: 10.1097/JHQ.0000000000000127
Original Article

Objectives: To determine the association between management standards and clinical outcomes among patients with hip fracture (HF).

Methods: Data from a prospective cohort study were linked with hospital administration data.

Results: In 2014 and 2015, 493 patients had surgery for HF. The proportion of patients meeting care standards ranged from 69% for surgery within 48 hours to 96% for being seen by a geriatrician. Thirty-nine per cent of patients received all the standards. The mean waiting time for surgery was 44 hours (median, 34 hours; interquartile range [IQR], 22–58 hours). The mean length of stay for patients who were alive at discharge was 17 days (median, 13 days; IQR, 6–24 days). Fifty-six patients were readmitted within 28 days of discharge (12%), and 40 patients died within 28 days of admission (8.1%). Patients who received all standards were less likely to be readmitted or die. Surgery within 48 hours and being seen by a physiotherapist were associated with a lower mortality rate.

Conclusions: The management standards, collectively and in particular, assessment by a physiotherapist and surgery within 48 hours were significantly associated with better clinical outcomes.

For more information on this article, contact Lieu Thi Thuy Trinh at Lieu.Trinh@health.nsw.gov.au.

All authors received salary from Western Sydney Local Health District. No external funding was received.

Author contributions: L. T. T. Trinh designed the study the study, applied for ethics clearance, obtained data, analyzed data, wrote the manuscript, and is the corresponding author. H. Achat contributed to the design of the study, provided advices and comments on data analyses and writing, and edited the final manuscript. S. M. Loh facilitated the data collection of the Hip Fracture Registry and provided advices and comments on data analyses and writing. R. Pascoe collected data for the Hip Fracture Registry, assisted in obtaining data, and provided advices and comments on data analyses and writing. H. Assareh contributed to the design of the study, provided advices and comments on data analyses and writing, and edited the final manuscript. J. Stubbs provided advices and comments on data analyses and writing and edited the final manuscript.

The authors declare no conflicts of interest.

© 2018 National Association for Healthcare Quality
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