Improving Hip Fracture Outcomes using Routinely Collected Health Data

Description

The presentation, led by David Metcalfe, focuses on the critical issue of hip fractures, particularly in the United Kingdom, where over 70,000 cases occur annually, leading to significant health and social care costs of more than £2 billion. Metcalfe discusses the gloomy statistics surrounding hip fracture recovery, revealing that only one-third of patients are home and independent one year post-injury, highlighting ongoing deficiencies in patient care. The presentation traces the historical context of patient care from Florence Nightingale's data-driven approach to modern practices, emphasizing the importance of the National Hip Fracture Database initiated to improve patient outcomes through data collection.



Metcalfe navigates the intricacies of assessing the effectiveness of healthcare initiatives such as the Best Practice Tariff, which incentivizes hospitals for meeting specific care criteria. He presents a natural experiment design that facilitates understanding of trends in hip fracture care and mortality rates by comparing data from England and Scotland, exploring variances in surgical intervention rates, especially regarding total hip replacements versus hemi-arthroplasties.



As the discussion progresses, Metcalfe reveals alarming disparities in patient treatment based on socio-economic status and hospital practices, including weekend admissions. He presents data from various hospitals to argue for the improvement of care standards and reveals how observational data can predict and influence clinical practices, urging for more streamlined data collection processes. In conclusion, Metcalfe advocates for enhanced integration of randomized controlled trial methodologies with national datasets to accelerate research outcomes and improve patient care across the board.

DOI: 10.1302/3114-221376

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