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Variation in care for patients presenting with hip fracture in six high‐income countries: A cross‐sectional cohort study.

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Title: Variation in care for patients presenting with hip fracture in six high‐income countries: A cross‐sectional cohort study.
Authors: Burrack, Nitzan (AUTHOR), Hatfield, Laura A. (AUTHOR), Bakx, Pieter (AUTHOR), Banerjee, Amitava (AUTHOR), Chen, Yu‐Chin (AUTHOR), Fu, Christina (AUTHOR), Godoy Junior, Carlos (AUTHOR), Gordon, Michal (AUTHOR), Heine, Renaud (AUTHOR), Huang, Nicole (AUTHOR), Ko, Dennis T. (AUTHOR), Lix, Lisa M. (AUTHOR), Novack, Victor (AUTHOR), Pasea, Laura (AUTHOR), Qiu, Feng (AUTHOR), Stukel, Therese A. (AUTHOR), Uyl‐de Groot, Carin (AUTHOR), Ravi, Bheeshma (AUTHOR), Al‐Azazi, Saeed (AUTHOR), Weinreb, Gabe (AUTHOR)
Source: Journal of the American Geriatrics Society. Dec2023, Vol. 71 Issue 12, p3780-3791. 12p.
Subjects: Internal fixation in fractures, Length of stay in hospitals, Developed countries, Total hip replacement, Cross-sectional method, Hip fractures, Retrospective studies, Acquisition of data, Hemiarthroplasty, Patient readmissions, Comparative studies, Osteoporosis, Medical records, Hospital care, Descriptive statistics, Research funding, Patient care, Longevity, Longitudinal method, Old age
Geographic Terms: Netherlands, United States, Taiwan, Israel, Canada, England
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. [ABSTRACT FROM AUTHOR]
Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Variation in care for patients presenting with hip fracture in six high‐income countries: A cross‐sectional cohort study.
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  Data: <searchLink fieldCode="AR" term="%22Burrack%2C+Nitzan%22">Burrack, Nitzan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hatfield%2C+Laura+A%2E%22">Hatfield, Laura A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bakx%2C+Pieter%22">Bakx, Pieter</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Banerjee%2C+Amitava%22">Banerjee, Amitava</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chen%2C+Yu‐Chin%22">Chen, Yu‐Chin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fu%2C+Christina%22">Fu, Christina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Godoy+Junior%2C+Carlos%22">Godoy Junior, Carlos</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gordon%2C+Michal%22">Gordon, Michal</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Heine%2C+Renaud%22">Heine, Renaud</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Huang%2C+Nicole%22">Huang, Nicole</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ko%2C+Dennis+T%2E%22">Ko, Dennis T.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lix%2C+Lisa+M%2E%22">Lix, Lisa M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Novack%2C+Victor%22">Novack, Victor</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pasea%2C+Laura%22">Pasea, Laura</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Qiu%2C+Feng%22">Qiu, Feng</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Stukel%2C+Therese+A%2E%22">Stukel, Therese A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Uyl‐de+Groot%2C+Carin%22">Uyl‐de Groot, Carin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ravi%2C+Bheeshma%22">Ravi, Bheeshma</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Al‐Azazi%2C+Saeed%22">Al‐Azazi, Saeed</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Weinreb%2C+Gabe%22">Weinreb, Gabe</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+the+American+Geriatrics+Society%22">Journal of the American Geriatrics Society</searchLink>. Dec2023, Vol. 71 Issue 12, p3780-3791. 12p.
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  Data: <searchLink fieldCode="DE" term="%22Internal+fixation+in+fractures%22">Internal fixation in fractures</searchLink><br /><searchLink fieldCode="DE" term="%22Length+of+stay+in+hospitals%22">Length of stay in hospitals</searchLink><br /><searchLink fieldCode="DE" term="%22Developed+countries%22">Developed countries</searchLink><br /><searchLink fieldCode="DE" term="%22Total+hip+replacement%22">Total hip replacement</searchLink><br /><searchLink fieldCode="DE" term="%22Cross-sectional+method%22">Cross-sectional method</searchLink><br /><searchLink fieldCode="DE" term="%22Hip+fractures%22">Hip fractures</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+studies%22">Retrospective studies</searchLink><br /><searchLink fieldCode="DE" term="%22Acquisition+of+data%22">Acquisition of data</searchLink><br /><searchLink fieldCode="DE" term="%22Hemiarthroplasty%22">Hemiarthroplasty</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+readmissions%22">Patient readmissions</searchLink><br /><searchLink fieldCode="DE" term="%22Comparative+studies%22">Comparative studies</searchLink><br /><searchLink fieldCode="DE" term="%22Osteoporosis%22">Osteoporosis</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+records%22">Medical records</searchLink><br /><searchLink fieldCode="DE" term="%22Hospital+care%22">Hospital care</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+care%22">Patient care</searchLink><br /><searchLink fieldCode="DE" term="%22Longevity%22">Longevity</searchLink><br /><searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink><br /><searchLink fieldCode="DE" term="%22Old+age%22">Old age</searchLink>
– Name: SubjectGeographic
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  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Netherlands%22">Netherlands</searchLink><br /><searchLink fieldCode="DE" term="%22United+States%22">United States</searchLink><br /><searchLink fieldCode="DE" term="%22Taiwan%22">Taiwan</searchLink><br /><searchLink fieldCode="DE" term="%22Israel%22">Israel</searchLink><br /><searchLink fieldCode="DE" term="%22Canada%22">Canada</searchLink><br /><searchLink fieldCode="DE" term="%22England%22">England</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: 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. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=174271129
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        Value: 10.1111/jgs.18530
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        Text: English
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      – SubjectFull: Internal fixation in fractures
        Type: general
      – SubjectFull: Length of stay in hospitals
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      – SubjectFull: Developed countries
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