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Length of hospital stay after hip fracture and short term risk of death after discharge: a total cohort study in Sweden

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h696 (Published 20 February 2015) Cite this as: BMJ 2015;350:h696

Rapid Response:

Quality of care: what went wrong between length of stay and risk of death?

To our knowledge, length of stay and risk of death are outcome measurements of quality of hospital care, in which better quality is linked to shorter length of stay and lower risk of death. In this study, shorter length of hospital stay after hip fracture is related to higher risk of death among patients with a length of stay of 10 days and less [1]. Another study about hip fracture patients found that lower quality of hospital care is associated with longer length of hospital stay, and higher mortality rates [2]. The issue raised is how to measure quality of care outcome when these two measurements are here and there not consistent.

For future research, besides considering diagnoses and type of operation, investigators should take into account the hospital volume or hip fracture unit volume as one of the important factors in analysis. In addition, it is necessary to determine the minimum length of stay to guarantee the quality of care and reduce the risk of death.

References
[1] Nordström P, Gustafson Y, Michaëlsson K, Nordström A. Length of hospital stay after hip fracture and short term risk of death after discharge: a total cohort study in Sweden. BMJ 2015;350:h696.

[2] Kristensen PK, Thillemann TM, Johnsen SP. Is bigger always better? A nationwide study of hip fracture unit volume, 30-day mortality, quality of in-hospital care, and length of hospital stay. Medical care 2014;52:1023-9.

Competing interests: No competing interests

12 March 2015
Van Tuyen Duong
Scientific Researcher
Taipei Medical University
No 250, Wuxing Street, Taipei City, Taiwan, 110