Hospitals’ hip fracture care falls short of targets

Shortcomings in the way hospitals deal with patients who have fractured their hip are identified in a new report.

More than one-quarter of patients with a hip fracture do not have surgery within the target time of 48 hours, the report by the National Office of Clinical Audit shows.

In half of these cases, this is because the patient is awaiting further medical review or stabilisation, but other factors causing a delay include waiting for a space on the operating theatre list or cancellation because of an overrun on the list.

The target to have patients with hip fractures admitted to an acute orthopaedic ward within four hours was achieved in just 23 per cent of cases.

Assessment and intervention

And while all patients who have suffered a fracture following a fall are supposed to be offered assessment and intervention to prevent future falls, this happened in only 64 per cent of cases.

Every year in Ireland, over 3,000 people are hospitalised with a hip fracture. This imposes significant costs on the health service, and has serious implications for the patients, 5 per cent of whom die in hospital. Over 70 per cent of the fractures were suffered by women; this rose to almost 80 per cent among those aged 90 or over.

The report, which looked at almost 2,000 cases discharged by 12 hospitals in 2013, found some improvements in care. More patients are receiving routine care from a geriatrician and the number of assessments to prevent further fractures and falls is increasing.

The number of hospitals contributing data on hip fractures is set to increase to 16 in future reports.