{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T23:37:16Z","timestamp":1793317036443,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T00:00:00Z","timestamp":1661904000000},"content-version":"vor","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000883","name":"University of Bristol","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000883","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012041","name":"Versus Arthritis","doi-asserted-by":"publisher","award":["22086"],"award-info":[{"award-number":["22086"]}],"id":[{"id":"10.13039\/501100012041","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Despite established standards and guidelines, substantial variation remains in the delivery of hip fracture care across the United Kingdom. We aimed to determine which hospital-level organisational factors predict adverse patient outcomes in the months following hip fracture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We examined a national record-linkage cohort of 178,757 patients aged \u226560\u00a0years who sustained a hip fracture in England and Wales in 2016\u201319. Patient-level hospital admissions datasets, National Hip Fracture Database and mortality data were linked to metrics from 18 hospital-level organisational-level audits and reports. Multilevel models identified organisational factors, independent of patient case-mix, associated with three patient outcomes: length of hospital stay (LOS), 30-day all-cause mortality and emergency 30-day readmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across hospitals mean LOS ranged from 12 to 41.9\u00a0days, mean 30-day mortality from 3.7 to 10.4% and mean readmission rates from 3.7 to 30.3%, overall means were 21.4\u00a0days, 7.3% and 15.3%, respectively. In all, 22 organisational factors were independently associated with LOS; e.g. a hospital\u2019s ability to mobilise &amp;gt;90% of patients promptly after surgery predicted a 2-day shorter LOS (95% confidence interval [CI]: 1.2\u20132.6). Ten organisational factors were independently associated with 30-day mortality; e.g. discussion of patient experience feedback at clinical governance meetings and provision of prompt surgery to &amp;gt;80% of patients were each associated with 10% lower mortality (95%CI: 5\u201315%). Nine organisational factors were independently associated with readmissions; e.g. readmissions were 17% lower if hospitals reported how soon community therapy would start after discharge (95%CI: 9\u201324%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Receipt of hip fracture care should be reliable and equitable across the country. We have identified multiple, potentially modifiable, organisational factors associated with important patient outcomes following hip fracture.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ageing\/afac183","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T09:11:20Z","timestamp":1661332280000},"source":"Crossref","is-referenced-by-count":37,"title":["Multiple hospital organisational factors are associated with adverse patient outcomes post-hip fracture in England and Wales: the REDUCE record-linkage cohort study"],"prefix":"10.1093","volume":"51","author":[{"given":"Rita","family":"Patel","sequence":"first","affiliation":[{"name":"University of Bristol Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, , Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Judge","sequence":"additional","affiliation":[{"name":"University of Bristol Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, , Bristol, UK"},{"name":"University of Oxford Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, , Oxford, UK"},{"name":"NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antony","family":"Johansen","sequence":"additional","affiliation":[{"name":"Cardiff University and University Hospital of Wales Division of Population Medicine, School of Medicine, , Cardiff, UK"},{"name":"Royal College of Physicians National Hip Fracture Database, , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsa M R","family":"Marques","sequence":"additional","affiliation":[{"name":"University of Bristol Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, , Bristol, UK"},{"name":"NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Griffin","sequence":"additional","affiliation":[{"name":"Royal Osteoporosis Society Clinical & Operations Directorate, , Bath, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Bradshaw","sequence":"additional","affiliation":[{"name":"University of Bristol Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, , Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Drew","sequence":"additional","affiliation":[{"name":"University of Bristol Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, , Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Whale","sequence":"additional","affiliation":[{"name":"University of Bristol Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, , Bristol, UK"},{"name":"NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Chesser","sequence":"additional","affiliation":[{"name":"Southmead Hospital, North Bristol NHS Trust Department of Trauma and Orthopaedics, , Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier L","family":"Griffin","sequence":"additional","affiliation":[{"name":"Queen Mary University of London Barts Bone and Joint Health, Barts and The London School of Medicine and Dentistry, , London, UK"},{"name":"Barts Health NHS Trust Royal London Hospital, , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad K","family":"Javaid","sequence":"additional","affiliation":[{"name":"University of Oxford Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, , Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoav","family":"Ben-Shlomo","sequence":"additional","affiliation":[{"name":"University of Bristol Population Health Sciences, Bristol Medical School, , Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celia L","family":"Gregson","sequence":"additional","affiliation":[{"name":"University of Bristol Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, , Bristol, UK"},{"name":"Royal United Hospital NHS Foundation Trust Bath Older People\u2019s Unit, , Combe Park, Bath, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,8,31]]},"reference":[{"key":"2022083100081448400_ref1","volume-title":"HES Data Dictionary: Admitted Patient Care","author":"Health and Social Care Information 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