National Hip Fracture Database Commissioners Report 2014

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). This report serves as a companion to the NHFD 2014 annual report and the CCG outcome indicators sets, available from the HSCIC indicators portal, and describes a number of outcome indicators aggregated to CCG and area team level. The audit covers England, Wales, Northern Ireland and the Isle of Man and, however data files only refer to data for England.髋部骨折（Hip fracture）是一种危害严重且医疗成本高昂的损伤，主要累及老年人群，且女性发病率更高。该病通常由骨量低下（骨质疏松症，osteoporosis）与跌倒共同诱发。全英国每年约发生7.6万例髋部骨折病例。尽管已有充分证据证实髋部骨折术后的手术、药物及康复护理的最佳实践方案，但此类护理服务及其转归——包括患者出院返家率与死亡率——仍存在显著差异。 国家髋部骨折数据库（National Hip Fracture Database, NHFD）于2007年启动，旨在改善髋部骨折患者的诊疗护理质量。该数据库记录了英格兰、威尔士及北爱尔兰地区髋部骨折患者的病例构成、诊疗护理情况与转归数据，目前累计收录病例已超25万例，是目前全球规模最大的髋部骨折临床审计数据库。 该数据库已证明在地方与国家层面均实现了患者护理质量的全面提升，在英格兰地区更助力英国卫生部成功推行了髋部骨折护理最佳实践收费标准（Best Practice Tariff）。目前其运作模式已在爱尔兰得到复制——爱尔兰髋部骨折数据库已于近期上线，澳大利亚、新西兰、加拿大及中国香港地区也在推进类似的数据库建设项目。 国家髋部骨折数据库由英国矫形外科医师协会（British Orthopaedic Association）与英国老年病学学会（British Geriatrics Society）合作创立，于2004年至2007年间完成开发。自2009年起，该数据库作为国家级临床审计项目，通过医疗质量改进伙伴关系（Healthcare Quality Improvement Partnership, HQIP）获得中央财政资助。2012年4月起，NHFD作为跌倒与脆性骨折审计项目的一部分持续运行，该项目由伦敦皇家内科医师学院（Royal College of Physicians (London)）代表HQIP进行管理。 本报告为NHFD 2014年度报告与临床委托小组（CCG）转归指标集的配套文档，相关指标集可通过卫生与社会护理信息中心（HSCIC）指标门户获取，本报告详述了聚合至CCG及区域团队层面的多项转归指标。 本次审计覆盖英格兰、威尔士、北爱尔兰与马恩岛，但本次数据集仅涵盖英格兰地区的相关数据。