Increasing early surgery within 2 days for hip fracture: a time trend in 15 EU countries (2000-13)

Maria Michela Gianino, Jacopo Lenzi, Marco Bonaudo, MariaPia Fantini, Roberta Siliquini, gualtiero ricciardi, Gianfranco Damiani

Research output: Contribution to journalArticle

Abstract

Objective: To analyse the trajectories of hip-fracture surgery rates within 2 days of admission to the hospital and the ratios of procedures initiated within the same day (Day 0) and the following day (Days 0-1) to procedures performed on the 2nd day. To study the association between socioeconomic, health input variables and early surgery.

Design: A pooled, cross-sectional, time-series analysis was used to evaluate secondary data from 15 European countries, during 2000-13.

Results: The rate of patients aged ≥65 years that were operated on within 2 days of hip-fracture has changed over time with an EU average annual increase of 0.42% (95% CI = 0.25, 0.59; P < 0.001) and with a significant linear trend. Multiple slopes from all the countries compete with this result. In contrast, the ratios of procedures initiated within the same day (Day 0) and the following day (Days 0-1) compared to procedures performed on the 2nd day are constant. No association was found between the rate of patients treated within 2 days of admission and demographic structure, health expenditure, health resources. However, the rate of patients treated within 2 days of admission is significantly associated with surgical volumes.

Conclusions: As the early surgery rate is growing, policy makers should be encouraged to undertake further policies to support the quality of care, and the providers should be driven to improve their organizational effectiveness by taking actions aimed at acting on specific organizational and logistical causes that represent a barrier to early surgery.

Original languageEnglish
JournalInternational Journal for Quality in Health Care
DOIs
Publication statusE-pub ahead of print - Nov 5 2018

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Hip Fractures
Quality of Health Care
Health Resources
Health Expenditures
Administrative Personnel
Demography
Health

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Increasing early surgery within 2 days for hip fracture : a time trend in 15 EU countries (2000-13). / Gianino, Maria Michela; Lenzi, Jacopo; Bonaudo, Marco; Fantini, MariaPia; Siliquini, Roberta; ricciardi, gualtiero; Damiani, Gianfranco.

In: International Journal for Quality in Health Care, 05.11.2018.

Research output: Contribution to journalArticle

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AU - Gianino, Maria Michela

AU - Lenzi, Jacopo

AU - Bonaudo, Marco

AU - Fantini, MariaPia

AU - Siliquini, Roberta

AU - ricciardi, gualtiero

AU - Damiani, Gianfranco

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N2 - Objective: To analyse the trajectories of hip-fracture surgery rates within 2 days of admission to the hospital and the ratios of procedures initiated within the same day (Day 0) and the following day (Days 0-1) to procedures performed on the 2nd day. To study the association between socioeconomic, health input variables and early surgery.Design: A pooled, cross-sectional, time-series analysis was used to evaluate secondary data from 15 European countries, during 2000-13.Results: The rate of patients aged ≥65 years that were operated on within 2 days of hip-fracture has changed over time with an EU average annual increase of 0.42% (95% CI = 0.25, 0.59; P < 0.001) and with a significant linear trend. Multiple slopes from all the countries compete with this result. In contrast, the ratios of procedures initiated within the same day (Day 0) and the following day (Days 0-1) compared to procedures performed on the 2nd day are constant. No association was found between the rate of patients treated within 2 days of admission and demographic structure, health expenditure, health resources. However, the rate of patients treated within 2 days of admission is significantly associated with surgical volumes.Conclusions: As the early surgery rate is growing, policy makers should be encouraged to undertake further policies to support the quality of care, and the providers should be driven to improve their organizational effectiveness by taking actions aimed at acting on specific organizational and logistical causes that represent a barrier to early surgery.

AB - Objective: To analyse the trajectories of hip-fracture surgery rates within 2 days of admission to the hospital and the ratios of procedures initiated within the same day (Day 0) and the following day (Days 0-1) to procedures performed on the 2nd day. To study the association between socioeconomic, health input variables and early surgery.Design: A pooled, cross-sectional, time-series analysis was used to evaluate secondary data from 15 European countries, during 2000-13.Results: The rate of patients aged ≥65 years that were operated on within 2 days of hip-fracture has changed over time with an EU average annual increase of 0.42% (95% CI = 0.25, 0.59; P < 0.001) and with a significant linear trend. Multiple slopes from all the countries compete with this result. In contrast, the ratios of procedures initiated within the same day (Day 0) and the following day (Days 0-1) compared to procedures performed on the 2nd day are constant. No association was found between the rate of patients treated within 2 days of admission and demographic structure, health expenditure, health resources. However, the rate of patients treated within 2 days of admission is significantly associated with surgical volumes.Conclusions: As the early surgery rate is growing, policy makers should be encouraged to undertake further policies to support the quality of care, and the providers should be driven to improve their organizational effectiveness by taking actions aimed at acting on specific organizational and logistical causes that represent a barrier to early surgery.

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