Variation in access to community rehabilitation services and length of stay in hospital following a hip fracture: a cross-sectional study

Neuburger, Jenny; Harding, Karen; Bradley, Rachel; Cromwell, David; Gregson, Celia L

doi:10.1136/bmjopen-2014-005469

Cited by 17 publications

(9 citation statements)

References 12 publications

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“…These include the quality and scope of the data. We addressed both in a previous study comparing diagnostic and procedure coding in HES and NHFD, 23 confirming the accuracy of diagnostic coding of hip fracture, a major and also a well-defined injury. We limited the analysis strictly to care processes that can be accurately measured using administrative data (i.e.…”

Section: Discussionsupporting

confidence: 55%

The Impact of a National Clinician-led Audit Initiative on Care and Mortality after Hip Fracture in England

Neuburger

Currie

Wakeman³

et al. 2015

Medical Care

182

149

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Background:Hip fracture is the most common serious injury of older people. The UK National Hip Fracture Database (NHFD) was launched in 2007 as a national collaborative, clinician-led audit initiative to improve the quality of hip fracture care, but has not yet been externally evaluated.Methods:We used routinely collected data on 471,590 older people (aged 60 years and older) admitted with a hip fracture to National Health Service (NHS) hospitals in England between 2003 and 2011. The main variables of interest were the use of early surgery (on day of admission, or day after) and mortality at 30 days from admission. We compared time trends in the periods 2003–2007 and 2007–2011 (before and after the launch of the NHFD), using Poisson regression models to adjust for demographic changes.Findings:The number of hospitals participating in the NHFD increased from 11 in 2007 to 175 in 2011. From 2007 to 2011, the rate of early surgery increased from 54.5% to 71.3%, whereas the rate had remained stable over the period 2003–2007. Thirty-day mortality fell from 10.9% to 8.5%, compared with a small reduction from 11.5% to 10.9% previously. The annual relative reduction in adjusted 30-day mortality was 1.8% per year in the period 2003–2007, compared with 7.6% per year over 2007–2011 (P<0.001 for the difference).Interpretation:The launch of a national clinician-led audit initiative was associated with substantial improvements in care and survival of older people with hip fracture in England.

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Section: Discussionsupporting

confidence: 55%

The Impact of a National Clinician-led Audit Initiative on Care and Mortality after Hip Fracture in England

Neuburger

Currie

Wakeman³

et al. 2015

Medical Care

182

149

View full text Add to dashboard Cite

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“…Rules and standards of referral may be barriers to, or facilitators of, access to a service d) Location of service delivery with the subcategories "location characteristics" and "catchment area". It is important to understand the characteristics of the place where a rehabilitation service is located (28). Questions could be whether it is a rural or urban area, whether it is connected to public transport, and whether there are any barriers to access.…”

Section: Discussionmentioning

confidence: 99%

International Classification of Service Organization in Rehabilitation: An updated set of categories (ICSO-R 2.0)

Gütenbrunner

Nugraha²,

Gimigliano³

et al. 2020

J Rehabil Med

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Rehabilitation services should be available worldwide for every person who has problems with functioning. Thus, rehabilitation services must be organized at all levels of healthcare, from the community, through primary care to general and specialized hospitals. Rehabilitation services are needed along the continuum of care: from acute, through post-acute to the chronic phase. In order to plan these services a classification system is needed to describe, in a uniform way, the different types of services and their characteristics. The second version of the International Classification System for Service Organization in Rehabilitation (ICSO-R 2.0), described in this paper, comprises 9 categories describing the provider of the service and 14 categories concerning service delivery. ICSO-R 2.0 will enable improved description of available service organization and facilitate the identification of rehabilitation service provision worldwide. Thus, the updated ICSO-R 2.0 will benefit all persons in need. Objective: To develop a revised version of the International Classification of Service Organization in Rehabilitation (ICSO-R). Design: Qualitative study. Methods: The revision was based on testing the first version of the ICSO-R; 2 discussion rounds invited by the ICSO-R working group of the Standardized Rehabilitation Reporting Subcommittee of the World Health Organization Liaison committee of the International Society of Physical and Rehabilitation Medicine, and a call for corrections from a group of international experts. Results: The resulting ICSO-R 2.0 version is composed of 2 dimensions (formerly 3); the Provider dimension and the Service delivery dimension. The categories of the Funding dimension from the first version of ICSO-R were incorporated into each of the other dimensions. The Provider dimension now consists of 9 categories and the Service delivery dimension consists of 14 categories. Subcategories have been added to 7 categories: governance/leadership, funding of provider, target groups, location of service delivery, setting, rehabilitation team, and funding of service delivery. Conclusion: This updated version of ICSO-R provides a prerequisite for rehabilitation service organization assessment and implementation projects, reporting of contextual influences in clinical trials and many other aspects. In addition, ICSO-R 2.0 can be used for several purposes, e.g. to analyse and compare the provision of rehabilitation services in health systems and to support the quality management of rehabilitation services. However, the development of value sets for each (sub)category and further validation studies are still needed.

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“…Although we cannot be sure that all transplant recipients were admitted to an English hospital after a fracture, the proportion admitted to other countries in the United Kingdom is likely to be small given that England accounts for over 85% of the population and we did not include patients transplanted in the other countries. Furthermore, the definitions of disease have not changed since 1995, and there is good concordance with hospital records and registry data regarding the incidence of hip fractures . We did not collect data on operative procedures performed after hip fracture, and this requires further investigation and will be the subject of future work.…”

Section: Discussionmentioning

confidence: 99%

Fracture risk and mortality post‐kidney transplantation

Ferro

Arnold

Bagnall

et al. 2015

Clinical Transplantation

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Variation in access to community rehabilitation services and length of stay in hospital following a hip fracture: a cross-sectional study

Cited by 17 publications

References 12 publications

The Impact of a National Clinician-led Audit Initiative on Care and Mortality after Hip Fracture in England

The Impact of a National Clinician-led Audit Initiative on Care and Mortality after Hip Fracture in England

International Classification of Service Organization in Rehabilitation: An updated set of categories (ICSO-R 2.0)

Fracture risk and mortality post‐kidney transplantation

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