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Report finds ongoing improvements but continued variation in care

Fuseworks Media
Fuseworks Media

The Australia and New Zealand Hip Fracture Registry (ANZHFR) has released its Annual Report on Monday 14th September.

The ANZHFR is gathering momentum and has collected data on over 50,000 hip fracture cases in people aged 50 years and older over the past five years, with Aotearoa New Zealand contributing 10,000 of these records. The focus of the ANZHFR is to improve the health care provided to older people admitted to hospital with a hip fracture and their health outcomes.

‘This year we have data on 86 percent of all hip fractures that occurred in 2019 and follow up to 120 days on 81 percent of these, which is a fantastic achievement,’ said Nicola Ward, NZ Clinical Co-ordinator.

Nineteen NZ hospitals have contributed to the report with all 22 hospitals that provide hip fracture surgery now collecting data.

The assessment and management of pain continues to be a focus, with 80 percent of hospitals now having a pain pathway. The use of nerve blocks to manage pain in the acute setting continues to increase to 67 percent, an increase from 56 percent.

‘We are incredibly pleased to see more hospitals developing a process to assess and manage hip fracture pain. However, there is still room for improvement,’ said Professor Jacqueline Close, Co-Chair of ANZHFR.

Half of all patients get their surgery within 26 hours of presenting to hospital, but a proportion are still waiting for more than 48 hours. Access to theatres and need for medical stabilisation are the primary reasons for delays.

‘Further work is needed on developing shared models of care where orthopaedic surgeons and geriatricians take joint responsibility for older hip fracture patients. Currently a third of patients are seen by a geriatrician before they have their surgery,’ said Dr Sarah Hurring, NZ Clinical Lead for ANZHFR.

The rate of bone health mediations remains low in people with previous fragility fractures but 69 percent of patients are on treatment at discharge from hospital.

‘We are committed to using this information to make improvements in the care we provide with the aim of getting more people back to their pre-fracture walking ability and returning home after their hospital stay,’ said Dr Hurring.

Hip fracture is the most serious and costly fall-related injury suffered by older people. Nearly 4,000 people in Aotearoa New Zealand break their hip each year, with the direct cost to the health service of approximately $171 million annually. A hip fracture case requiring a three-week admission to hospital will cost on average $47,000.

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