Cristin-prosjekt-ID: 545443
Registrert av: SPREK Sist endret: 9. juni 2019 14:30

Cristin-prosjekt-ID: 545443
Registrert av: SPREK Sist endret: 9. juni 2019 14:30
Prosjekt

Pasientforløp hos eldre med hoftebrudd

prosjektleder

Sabine Ruths
ved Uni Research AS ved NORCE Norwegian Research Centre AS

prosjekteier / koordinerende forskningsansvarlig enhet

  • Uni Research AS ved NORCE Norwegian Research Centre AS

Godkjenninger

  • Regionale komitéer for medisinsk og helsefaglig forskningsetikk (REK) - 2013/1306

Finansiering

  • Norges forskningsråd
    Prosjektkode: 222141/H10

Klassifisering

Emneord

Lårhalsbrudd • Hoftebrudd • Overlevelse • Helsetjenesteforskning • Helserelatert livskvalitet

Kategorier

Prosjektkategori

  • Anvendt forskning

Helseprosjekttype

Annet studium

Kontaktinformasjon

Sted
Sabine Ruths

Tidsramme

Aktivt
Start: 1. september 2013 Slutt: 31. desember 2020

Beskrivelse Beskrivelse

Tittel

Pasientforløp hos eldre med hoftebrudd

Populærvitenskapelig sammendrag

Bakgrunn: Hvert år får ca 9000 personer i Norge et hoftebrudd, ca 90% av bruddene er primære. Etter operasjon trenger de fleste pasienter rehabilitering i form av hjemmebaserte tjenester eller helseinstitusjon. Tilgjengelige helsetjenester varierer melom ulike kommuner.

Formål: Kartlegge pasientforløp i fht behandling og endepunkter gjennom det første året etter hoftebrudd. Delmål: 1)Undersøke sammenheng mellom ressurser på kommunalt nivå og endepunkter på individnivå. 2) Undersøke sammenheng mellom geografisk nærhet til sykehus (sentralitet) og nasjonale kvalitetsindikatorer.

Vitenskapelig sammendrag

BACKGROUND:

Hip fractures represent major critical events for older people, and put huge demands on economic and personnel resources. Most hip fracture patients are in need of postoperative rehabilitation services. Through the Coordination Reform, the municipalities in Norway were given increased responsibility for community-based treatment and rehabilitation after surgery. The purpose of this study was to examine associations between municipal resources and patient outcomes through the first year after a hip fracture, focusing on survival and health-related quality of life.

METHODS:

We conducted a nationwide cohort study on people experiencing a hip fracture in 2011-2012 in Norway, with a 1-year follow-up. We obtained data on date of hip fracture, demographics, total morbidity (ASA) score, health-related quality of life (EQ-5D-3 L), date of death if applicable, municipality of residence (Norwegian Hip Fracture Register), date of hospital readmission due to complications (Norwegian Patient Register), and information on municipalities' characteristics (Municipality-State-Reporting).

RESULTS:

The study population comprised 15,757 patients, mean age 80.8 years, 68.6% women. All-cause mortality was 8.6% at 30 days, and 25.3% at 12 months. Mortality was lower in the municipalities with the highest overall staff time for rehabilitation. A high proportion of the population aged 80+, was associated with low rates of self-reported anxiety/depression 12 months after surgery, as well as higher general health scores (EQ-5D VAS). There were no other differences in outcome according to rehabilitation resources, when comparing municipalities with the highest and lowest staffing.

CONCLUSION:

The study revealed no substantial impact of municipal resources on survival and health-related quality of life through the first year after a hip fracture. To evaluate major organizational changes and allocate resources according to best practice, there is a need to monitor health outcomes and use of resources over time through reliable measures, including variables related to coordination between services.

Tittel

Patient trajectories in older patients with hip fractures

Populærvitenskapelig sammendrag

Hip fracture is a critical life event that often causes functional decline, nursing home admission and early death. Most hip fracture patients are in need of postoperative rehabilitation services. Through the Coordination Reform, the municipalities in Norway were given increased responsibility for community-based treatment and rehabilitation after surgery.

The purpose of this study was to examine associations between municipal resources and patient outcomes through the first year after a hip fracture, focusing on survival and health-related quality of life.

We conducted a nationwide cohort study on 15,757 patients (mean age 81 years, 69% women) experiencing a hip fracture in 2011–2012 in Norway, with a 1-year follow-up. We obtained data on date of hip fracture, demographics, total morbidity (ASA) score, health-related quality of life (EQ-5D-3 L), date of death if applicable, municipality of residence (Norwegian Hip Fracture Register), date of hospital readmission due to complications (Norwegian Patient Register), and information on municipalities’ characteristics (Municipality-State-Reporting).

Vitenskapelig sammendrag

BACKGROUND:

Hip fractures represent major critical events for older people, and put huge demands on economic and personnel resources. Most hip fracture patients are in need of postoperative rehabilitation services. Through the Coordination Reform, the municipalities in Norway were given increased responsibility for community-based treatment and rehabilitation after surgery. The purpose of this study was to examine associations between municipal resources and patient outcomes through the first year after a hip fracture, focusing on survival and health-related quality of life.

METHODS:

We conducted a nationwide cohort study on people experiencing a hip fracture in 2011-2012 in Norway, with a 1-year follow-up. We obtained data on date of hip fracture, demographics, total morbidity (ASA) score, health-related quality of life (EQ-5D-3 L), date of death if applicable, municipality of residence (Norwegian Hip Fracture Register), date of hospital readmission due to complications (Norwegian Patient Register), and information on municipalities' characteristics (Municipality-State-Reporting).

RESULTS:

The study population comprised 15,757 patients, mean age 80.8 years, 68.6% women. All-cause mortality was 8.6% at 30 days, and 25.3% at 12 months. Mortality was lower in the municipalities with the highest overall staff time for rehabilitation. A high proportion of the population aged 80+, was associated with low rates of self-reported anxiety/depression 12 months after surgery, as well as higher general health scores (EQ-5D VAS). There were no other differences in outcome according to rehabilitation resources, when comparing municipalities with the highest and lowest staffing.

CONCLUSION:

The study revealed no substantial impact of municipal resources on survival and health-related quality of life through the first year after a hip fracture. To evaluate major organizational changes and allocate resources according to best practice, there is a need to monitor health outcomes and use of resources over time through reliable measures, including variables related to coordination between services.

 

prosjektdeltakere

prosjektleder
Aktiv cristin-person

Sabine Ruths

  • Tilknyttet:
    Prosjektleder
    ved Uni Research AS ved NORCE Norwegian Research Centre AS
  • Tilknyttet:
    Prosjektdeltaker
    ved Universitetet i Bergen

Valborg Baste

  • Tilknyttet:
    Prosjektdeltaker
    ved Uni Research Helse ved NORCE Norwegian Research Centre AS

Marit Stordal Bakken

  • Tilknyttet:
    Prosjektdeltaker
    ved Haraldsplass Diakonale sykehus​ ved Private ideelle i Helse Vest

Siren Haugland

  • Tilknyttet:
    Prosjektdeltaker
    ved Uni Research AS ved NORCE Norwegian Research Centre AS
Aktiv cristin-person

Stein Atle Lie

  • Tilknyttet:
    Prosjektdeltaker
    ved Institutt for klinisk odontologi ved Universitetet i Bergen
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Resultater Resultater

Municipal resources and patient outcomes through the first year after a hip fracture.

Ruths, Sabine; Baste, Valborg; Bakken, Marit Stordal; Engesæter, Lars B.; Lie, Stein Atle; Haugland, Siren. 2017, BMC Health Services Research. NORCE, HAUKELAND, UIBVitenskapelig artikkel
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