Smitten Hips: costs, complexities and consequences of hip fracture for 2552 Australian patients hospitalised in 2008–09. Analyses of linked Department of Veterans’ Affairs databases

摘要

This work describes hospital management and its aftermaths for a sample of 2552 elderly Australians with hip fracture. Administrative databases for hospital, residential aged care and community services were obtained from the Department of Veterans’ Affairs (DVA). Patient-level linkages within and between databases were enabled using unique code numbers assigned by DVA.udAn historical and epidemiological overview of Australian and international reports, with particular reference to declining age-related incidence includes a caseload projection for Australia to 2051 using national data in the public domain.udFive specific research studies describe the total hospital stay for initial management, hospital-related cost (in 2009), the proportions of hospital stay due to acute care, rehabilitation and other reasons, and factors associated with greater use of resources. Mortality for this elderly population is shown at final hospital discharge, and at follow-up to 4 years, with determinant factors for these outcomes. The six Australian states used widely different hospital resources initial management but achieved very similar 12-month outcomes. Patients referred to rehabilitation incurred much higher total hospital costs, but likelihood of subsequent independent living was not improved.udThe Thesis demonstrates the necessity of data linkage for adequate analysis of services and outcomes for patients with complex conditions