Re: Length of hospital stay after hip fracture and short term risk of death after discharge: a total cohort study in Sweden
We have analysed our fractured neck of femur data collected between September 2008 and December 2014. Data was initially collected for a local audit but later for National Hip Fracture Database (NHFD) requirements. We sub-analysed our data because of concern that patients admitted from some Clinical Commissioning Groups took much longer to be discharged than patients from elsewhere. The aims of the audit were to discover whether the concern was valid, and if so, what the reasons may be. Details of 1813 patients were available. The audit found that the mean, length of stay of patients from one CCG was 3 days more than the others. Few reasons for this were found in patient demographics including age, mental and physical state and promptness of surgery. Total extra bed days for the 660 CCG A patients were 1980 days over the 6.25 years. Our mean length of stay is poor at 27 days but we get 67% of patient discharged to their home.
A simple analysis of NHFD data that there is a disparity between length of stay and successful home discharge, it can be seen from the graph in 2013's and 2014's report that the top 10 performing hospitals in terms of length of stay only achieved a 29% home discharge rate. We note that the report considered it an improvement that the mean had shifted between 46.4 to 48% between 2013 and 2014 and a good rate of home discharge is commended. We noted that our worst performing CCG in terms of days in hospital did have more patients discharged to their own homes and for this reason should find some congratulations. We do however note that their excess stays of around 3 days has lead to 1980 extra bed days over the 6.25 years.
National Reports 2013/14 (2014). London: National Hip Fracture Database. Available at: http://www.nhfd.co.uk
Competing interests:
No competing interests
15 March 2015
Martin Sharrock
Medical Student
Ronnie Davies, Philomena Smith, Martyn Lovell
Manchester Medical School
University Hospital South Manchester, Manchester. M23 9LT
Rapid Response:
Re: Length of hospital stay after hip fracture and short term risk of death after discharge: a total cohort study in Sweden
We have analysed our fractured neck of femur data collected between September 2008 and December 2014. Data was initially collected for a local audit but later for National Hip Fracture Database (NHFD) requirements. We sub-analysed our data because of concern that patients admitted from some Clinical Commissioning Groups took much longer to be discharged than patients from elsewhere. The aims of the audit were to discover whether the concern was valid, and if so, what the reasons may be. Details of 1813 patients were available. The audit found that the mean, length of stay of patients from one CCG was 3 days more than the others. Few reasons for this were found in patient demographics including age, mental and physical state and promptness of surgery. Total extra bed days for the 660 CCG A patients were 1980 days over the 6.25 years. Our mean length of stay is poor at 27 days but we get 67% of patient discharged to their home.
A simple analysis of NHFD data that there is a disparity between length of stay and successful home discharge, it can be seen from the graph in 2013's and 2014's report that the top 10 performing hospitals in terms of length of stay only achieved a 29% home discharge rate. We note that the report considered it an improvement that the mean had shifted between 46.4 to 48% between 2013 and 2014 and a good rate of home discharge is commended. We noted that our worst performing CCG in terms of days in hospital did have more patients discharged to their own homes and for this reason should find some congratulations. We do however note that their excess stays of around 3 days has lead to 1980 extra bed days over the 6.25 years.
National Reports 2013/14 (2014). London: National Hip Fracture Database. Available at: http://www.nhfd.co.uk
Competing interests: No competing interests