National Hip Fracture Database Annual Report 2011-12

Hip fracture is a serious and costly injury affecting mainly older people, and is more common in women. It usually results from the combination of weak bone structure (osteoporosis) and a fall. Around 76,000 hip fractures occur each year in the UK as a whole. Although there is good evidence on best practice in surgical, medical and rehabilitation care following hip fracture, such care and its outcomes – in terms of return home and also of mortality – continues to vary.

The National Hip Fracture Database (NHFD), which was launched in 2007,
aims to deliver improvements in the care of hip fracture patients. It documents case-mix, care and outcomes of hip fracture patients in England, Wales and Northern Ireland and is now, with more than 250,000 cases on record – by far the largest hip fracture audit in the world.

It has demonstrated broad improvements at local and national level in patient care, and in England has supported the Department of Health’s highly successful Best Practice Tariff for hip fracture care. The work of the NHFD is now being replicated in Ireland, with the recent launch of Irish Hip Fracture Database, and similar developments are in hand in Australia and New Zealand, Canada and Hong Kong.
The National Hip Fracture Database was founded as a collaboration between the British Orthopaedic Association and the British Geriatrics Society. It was developed between 2004 and 2007, and since 2009 it has received central funding as a national clinical audit via the Healthcare Quality Improvement Partnership (HQIP). Since April 2012 the NHFD has continued as part of the Falls and Fragility Fracture Audit Programme, managed on behalf of HQIP by the Royal College of Physicians (London).

The audit covers England, Wales, Northern Ireland, the Isle of Man and the Channel Islands, however data files only refer to data for England.

髋部骨折是一种严重且昂贵的损伤，主要影响老年人，女性发病率更高。通常，该损伤由骨结构脆弱（骨质疏松症）与跌倒的共同作用所致。在英国，每年约有76,000例髋部骨折发生。尽管关于髋部骨折术后最佳护理实践在手术、医疗和康复方面的证据充足，但此类护理及其结果——包括回家以及死亡率——的差异性依然存在。

国家髋部骨折数据库（NHFD）于2007年启动，旨在提升髋部骨折患者的护理质量。该数据库记录了英格兰、威尔士和北爱尔兰髋部骨折患者的病例组合、护理和结果，目前已累积超过250,000个案例，成为世界上规模最大的髋部骨折审计项目。

NHFD已在地方和国家级别证明了对患者护理的广泛改善，并在英格兰支持了卫生部高度成功的最佳实践收费标准。NHFD的工作现已复制到爱尔兰，近期推出了爱尔兰髋部骨折数据库，类似的进展也在澳大利亚、新西兰、加拿大和香港展开。

国家髋部骨折数据库是由英国骨科协会和英国老年病学学会合作成立的。该数据库于2004年至2007年期间开发，自2009年起作为国家临床审计项目获得中央资助，由医疗保健质量改进伙伴关系（HQIP）提供资金支持。自2012年4月起，NHFD作为跌倒和脆性骨折审计项目的一部分继续运行，该项目由伦敦皇家内科医师学院代表HQIP管理。

审计范围包括英格兰、威尔士、北爱尔兰、马恩岛和海峡群岛，然而数据文件仅涉及英格兰的数据。