Over 3000 older people in Ireland experience hip fracture annually. These serious events have a one-year mortality rate of 20% and account for 3% of public health expenditure. Since 2013, the Irish Hip Fracture Database (IHFD) has driven national clinical improvement and reduced variability of care across hospitals. Similar improvements in the UK have improved survival rates. As most services do not conduct routine follow-up after hip fracture, we do not know whether this is true in Ireland. Furthermore, international research has found that hip fracture care quality and outcomes are influenced by where patients live geographically. This needs investigation in Ireland.
The IHFD will soon allow for recording of longer-term hip fracture outcomes. Hospitals need to be supported to conduct this follow-up through education about methods that are acceptable to patients and that have been successful in Ireland and internationally. The IHFD will also need best-evidence tools to benchmark outcomes nationally.
The overall aims of this project are:
To facilitate the accurate and acceptable collection of long-term outcomes after hip fracture in Ireland.
To develop methods for making comparisons of hip fracture care and outcomes across hospital sites and geographic areas.
These aims will be addressed through three inter-related Work Packages (WP):
WP1: Education for local co-ordinators of long-term outcome collection in Ireland will be developed through a systematic review of Irish literature, a qualitative focus-group study and input from patients, professionals and international researchers.
WP2: National analysis of geographic variation of current indicators of quality hip fracture care will be conducted, exploring patient-level, service-level and societal-level factors that may influence quality.
WP3: Previously derived multivariable prediction models for hip fracture outcomes will be identified, appraised and evaluated for national use in Ireland. This will enable long-term outcome data, when collected, to be used to inform national care.
