{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T17:19:01Z","timestamp":1781716741948,"version":"3.54.5"},"reference-count":30,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,10,31]]},"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To determine if the introduction of the best practice tariff (BPT) has improved survival of the elderly hip fracture population, or if achieving BPT results in improved survival for an individual.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>A single university-affiliated teaching hospital.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>2541 patients aged over 60 admitted with a neck of femur fracture between 2008 and 2010 and from 2012 to 2014 were included, to create two cohorts of patients, before and after the introduction of BPT. The post-BPT cohort was divided into two groups, those who achieved the criteria and those who did not.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary and secondary outcome measures<\/jats:title>\n                  <jats:p>Primary outcomes of interest were differences in mortality across cohorts. Secondary analysis was performed to identify associations between individual BPT criteria and mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The introduction of BPT did not significantly alter overall 30-mortality in the hip fracture population (8.3% pre-BPT vs 10.0% post-BPT; p=0.128). Neither was there a significant reduction in length of stay (15\u2005days (IQR 9\u201321) pre-BPT vs 14\u2005days (IQR 11\u201322); p=0.236). However, the introduction of BPT was associated with a reduction in the time from admission to theatre (median 44\u2005hours pre-BPT (IQR 24\u201344) vs 23\u2005hours post-BPT (IQR 17\u201330); p&lt;0.005). 30-day mortality in those who achieved BPT was significantly lower (6.0% vs 21.0% in those who did not achieve-BPT; p&lt;0.005). There was a survival benefit at 1\u2005year for those who achieved BPT (28.6% vs 42.0% did not achieve-BPT; p&lt;0.005). Multivariate logistic regression revealed that of the BPT criteria, AMT monitoring and expedited surgery were the only BPT criteria that significantly influenced survival.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The introduction of the BPT has not led to a demonstrable improvement in outcomes at organisational level, though other factors may have confounded any benefits. However, patients where BPT criteria are met appear to have improved outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-014190","type":"journal-article","created":{"date-parts":[[2017,2,6]],"date-time":"2017-02-06T20:50:11Z","timestamp":1486414211000},"page":"e014190","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":71,"title":["Does achieving the best practice tariff improve outcomes in hip fracture patients? An observational cohort study"],"prefix":"10.1136","volume":"7","author":[{"given":"B","family":"Oakley","sequence":"first","affiliation":[{"name":"Department of Trauma and Orthopaedics, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Nightingale","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CG","family":"Moran","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"IK","family":"Moppett","sequence":"additional","affiliation":[{"name":"Anaesthesia and Critical Care Section, Division of Clinical Neuroscience, Queen's Medical Centre, University of Nottingham, Nottingham, UK"},{"name":"Department of Anaesthesia, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,2,6]]},"reference":[{"key":"2025101812210997000_7.2.e014190.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2008.11.004"},{"key":"2025101812210997000_7.2.e014190.2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01623184"},{"key":"2025101812210997000_7.2.e014190.3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-004405"},{"key":"2025101812210997000_7.2.e014190.4","unstructured":"Royal College of Physicians. 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