A new study has discovered “significant variations” in spending and care provision for hip facture patients across NHS hospitals in England and Wales.
The research, which was led by the University of Bristol and funded by the charity Versus Arthritis, found that people spent an average of 32 days in hospital in the year following their hip fracture, leading to an average cost of £14,642 per patient.
But, using data accrued from 178,757 patients at 172 hospital sites, researchers discovered that figure could rise to £23,188 per patient in some places, with the lowest being £10,867.
The research team say that costs were reduced when patients had access to physiotherapy throughout the week and thus didn’t spend as long in hospital.
This further validates the vital role consultant geriatricians who specialise in fractures – also known as orthogeriatricians – play in this field, according to the researchers.
Senior research associate in medical statistics at the university, Dr Rita Patel, explained: “If a consultant orthogeriatrician attends hospital clinical governance meetings, a further cost saving of £356 per patient could potentially be achieved, as well as patients spending fewer days spent in the hospital in the year following hip fracture.”
“Hospitals with fracture liaison services also have lower mortality rates and patients spend fewer days in hospital. Our study suggests that rather than increasing the burden on the NHS, providing additional care for patients with orthogeriatrician and fracture liaison services may actually improve NHS efficiency.”
The people behind the findings have already established a solution to the problems outlined in the study – a toolkit which was developed in conjunction with the Royal Osteoporosis Society, and informed by the research.
Freely available to all healthcare professionals, the resource sets out how 172 acute hospital settings across England and Wales can improve the quality of their fracture services.
Professor in clinical epidemiology at the University of Bristol, Celia Gregson, added: "The variation we have seen in patient outcomes and health spending following hip fracture are difficult to justify on purely clinical grounds, it tells us that the way we organise the delivery of care can be improved nationally.
“By prioritising orthogeriatrician assessment, getting patients out of bed promptly after surgery, providing seven-day physiotherapy, reducing delirium risk for patients, and holding monthly multidisciplinary clinical governance meetings, hospitals stand to improve patient outcomes and reduce their healthcare spending."
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