Hospital case volume and outcomes for proximal femoral fractures in the USA: an observational study

Metcalfe, David, Salim, Ali, Olufajo, Olubode, Gabbe, Belinda, Zogg, Cheryl, Harris, Mitchel B, Perry, Daniel C ORCID: 0000-0001-8420-8252 and Costa, Matthew L (2016) Hospital case volume and outcomes for proximal femoral fractures in the USA: an observational study. BMJ OPEN, 6 (4). e010743-.

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Abstract

<h4>Objective</h4>To explore whether older adults with isolated hip fractures benefit from treatment in high-volume hospitals.<h4>Design</h4>Population-based observational study.<h4>Setting</h4>All acute hospitals in California, USA.<h4>Participants</h4>All individuals aged ≥65 that underwent an operation for an isolated hip fracture in California between 2007 and 2011. Patients transferred between hospitals were excluded.<h4>Primary and secondary outcomes</h4>Quality indicators (time to surgery) and patient outcomes (length of stay, in-hospital mortality, unplanned 30-day readmission, and selected complications).<h4>Results</h4>91,401 individuals satisfied the inclusion criteria. Time to operation and length of stay were significantly prolonged in low-volume hospitals, by 1.96 (95% CI 1.20 to 2.73) and 0.70 (0.38 to 1.03) days, respectively. However, there were no differences in clinical outcomes, including in-hospital mortality, 30-day re-admission, and rates of pneumonia, pressure ulcers, and venous thromboembolism.<h4>Conclusions</h4>These data suggest that there is no patient safety imperative to limit hip fracture care to high-volume hospitals.

Item Type:	Article
Uncontrolled Keywords:	Hip, Femur, Humans, Femoral Fractures, Hip Fractures, Hospitalization, Length of Stay, Patient Readmission, Hospital Mortality, Aged, Aged, 80 and over, Quality of Health Care, United States, California, Female, Male, Hospitals, High-Volume, Hospitals, Low-Volume, Outcome Assessment, Health Care
Depositing User:	Symplectic Admin
Date Deposited:	23 Jan 2017 12:31
Last Modified:	19 Jan 2023 07:20
DOI:	10.1136/bmjopen-2015-010743
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3005347