There are significant variations in healthcare spending and care delivery across NHS hospitals in England and Wales following hip fracture, a new study aimed at understanding how hospital care impacts patients’ outcomes and costs has revealed.
The study, led by the University of Bristol and funded by Versus Arthritis, highlights the urgent need for evidence-based quality improvement strategies to reduce healthcare spending and improve patient outcomes in the year following a hip fracture. The research is published online in The Lancet Healthy Longevity today [10 July].
Hip fracture is a serious health concern, with more than 70,000 older adults admitted to a UK hospital each year. This study highlights the high healthcare burden associated with breaking a hip.
The research analysed data from national databases for 178,757 hip fracture patients aged 60 years and above in England and Wales, who broke their hip between 2016 and 2019, followed up to just before the pandemic. More than one in four patients died within a year of their hip fracture.
Patients spent an average of 32 days in hospital in the year following a hip fracture, resulting in substantial inpatient costs of on average £14,642 per patient – a cost similar to that incurred in the year after a stroke, and that exceeds costs of many common cancers. But this cost varied substantially between hospitals, with more than a two-fold difference in spending, ranging from £10,867 to £23,188 per patient, between NHS hospitals studied in England and Wales.
The researchers identified that in hospitals where patients are up and about quickly after their operation and where physiotherapy is provided seven days a week, patient costs were lower, the risk of sudden confusion (delirium) was reduced, and patients spent fewer days in hospital in the year following hip fracture.
The research further highlighted the crucial role of orthogeriatricians – consultant geriatricians who specialise in the care of people with fractures- in hip fracture care.
Dr Petra Baji, Senior Research Associate in Health Economics at Bristol Medical School: Translational Health Sciences (THS) and the paper’s first author, explained: “The findings suggest that having all patients assessed by an orthogeriatrician within the first days of admission could cut healthcare spending by £529 per patient, as well as reduce the chance of dying by 15% in the year following hip fracture.”
Dr Rita Patel, Senior Research Associate in Medical Statistics at Bristol and statistician for the study, added: “If a consultant orthogeriatrician att