Improvements in Hip Fracture Care are Increasing Patients’ Longevity

Britian’s National Hip Fracture Database (NHFD) national report 2014 shows that improvements in care bolster patient survival after hip fractures.

In 2013 the average 30-day mortality slipped to 8.05 percent from 8.1 percent during2011-2012. The change seems statistically insignificant but results in 300 fewer hip fracture deaths.

The NHFD audit is commissioned by the Healthcare Quality Improvement Partnership as part of the National Clinical Audit and Patient Outcomes Programme. The NHFD audit is carried out by the Royal College of Physicians.

Care is improving in many areas including the time it take for patients to get to the hospital and their access to a specialist consultant (orthogeriatrician). More patients (71.7 percent) are getting to the hospital on the day of admission or the day after for surgery. This is a small increase from 70.6 percent reported in 2013. More patients (81.6 percent) have access to an orthogeriatrician today compared with only a quarter of patients in 2009. Improving such aspects of care explains the improvements in performance in recent years.

“This report marks a positive set of annual results, which show how overall hip fracture care has continued to improve year on year since the audit started in 2007. These improvements are against backdrop of an increase in the number of patients being treated and an increase in the average age of the hip fracture patient,” said Antony Johansen, M.D., NHFD clinical lead, orthogeriatric medicine. “Almost 50 percent (47.4 percent) of patients are being admitted to an orthopaedic ward within four hours of arriving at hospital. But there has been a slight dip in this result compared with last year’s national report (48.9 percent).”

Professor PaulKnight, president of the British Geriatrics Society (BGS), added, “We welcome this report that shows once again that planned multidisciplinary care for older people has the capacity to improve outcomes and we would commend the methodology of the audit to others engaged in health service provision.”