Hip fractures: mortality, economic burden, and organisational factors for improved patient outcomes

Hip fractures are associated with high mortality and a substantial economic burden. Although many studies have investigated patient characteristics or surgical procedures related to mortality and economic burden, very few have examined the hospital-level factors associated with hip fracture mortality and costs. Petra Baji and colleagues’ study in The Lancet Healthy Longevity addresses an important research gap by focusing on multiple organisational factors. By examining the variation in hip fracture care delivery in 172 National Health Service hospitals in England and Wales, the findings have implications for researchers, clinicians, and health service funders and managers.

The authors investigated 89 organisational factors that were relevant to costs and length of patient stay in the hospital, and 105 factors that were relevant to mortality outcomes within 365 days of an index hip fracture. The findings showed that 11 organisational factors were independently associated with mortality at 365 days, including six factors associated with a reduced risk of death and five factors associated with an increased risk of death...