Hip fractures in Manitoba, an evaluation of the quality of care

Abstract

Problem. Roos et al. (1990) compared mortality rates following various surgical procedures in Manitoba and New England. Individuals treated with procedures with a high mortality rate, hip fracture repair and bypass surgery, had a higher risk of death in Manitoba within the first year after surgery than in New England. However, the survival for other surgical procedures was better in Manitoba. These findings suggest the need for evaluating the quality of hip fracture care in Manitoba. Method. All hip fracture patients, age 65 years and over, in their initial episode of care from April 1, 1979 to March 31, 1993 (N = 12,271) in Manitoba were identified from hospital abstracts in the provincial health insurance system. Death at three months, death between three months and one year, readmission within one year, nursing home admission within one year, occurrence of a second hip fracture, diagnosis of a late effect of hip fracture care, a repeat primary repair procedure, a secondary repair procedure and length of stay greater than 100 days were the adverse outcomes studied. The predictors of adverse outcomes were examined using multivariate analysis. (Abstract shortened by UMI.)