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Does performance-based remuneration improve outcomes in the treatment of hip fracture?
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Griffin, Xavier L., Achten, Juul, Parsons, Nick and Costa, Matt L. (2021) Does performance-based remuneration improve outcomes in the treatment of hip fracture? The Bone & Joint Journal, 103-B (5). pp. 881-887. doi:10.1302/0301-620x.103b5.bjj-2020-1839.r1 ISSN 2049-4408.
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0301-620x.103b5.bjj-2020-1839.r1.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution Non-commercial No Derivatives 4.0. Download (424Kb) | Preview |
Official URL: http://doi.org/10.1302/0301-620x.103b5.bjj-2020-18...
Abstract
Aims: The aim of this study was to determine whether national standards of best practice are associated with improved health-related quality of life (HRQoL) outcomes in hip fracture patients.
Methods: This was a multicentre cohort study conducted in 20 acute UK NHS hospitals treating hip fracture patients. Patients aged ≥ 60 years treated operatively for a hip fracture were eligible for inclusion. Regression models were fitted to each of the “Best Practice Tariff” indicators and overall attainment. The impact of attainment on HRQoL was assessed by quantifying improvement in EuroQol five-dimension five-level questionnaire (EQ-5D-5L) from estimated regression model coefficients.
Results: A total of 6,532 patients provided both baseline and four-month EQ-5D-5L, of whom 1,060 participants had died at follow-up. Best practice was achieved in the care of 57% of participants; there was no difference in age, cognitive ability, and mobility at baseline for the overall attainment and non-attainment groups. Attaining at least ‘joint care by surgeon and orthogeriatrician’, ‘delirium assessment’, and ‘falls assessment’ was associated with a large, clinically relevant increase in four months EQ-5D-5L of 0.094 (bootstrapped 95% confidence interval (CI) 0.046 to 0.146).
Conclusion: National standards with enhanced remuneration in hip fracture care results in improvement in individual patients’ HRQoL. Cite this article: Bone Joint J 2021;103-B(5):881–887.
Item Type: | Journal Article | ||||||
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Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RD Surgery |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||
SWORD Depositor: | Library Publications Router | ||||||
Library of Congress Subject Headings (LCSH): | Hip joint -- Fractures, Hip joint -- Fractures -- Patients -- Rehabilitation, Great Britain. National Health Service -- Auditing, Great Britain. National Health Service -- Cost control, Medical care -- Quality control -- Great Britain, Hospitals -- Business management -- Great Britain | ||||||
Journal or Publication Title: | The Bone & Joint Journal | ||||||
Publisher: | British Editorial Society of Bone & Joint Surgery | ||||||
ISSN: | 2049-4408 | ||||||
Official Date: | 1 May 2021 | ||||||
Dates: |
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Volume: | 103-B | ||||||
Number: | 5 | ||||||
Page Range: | pp. 881-887 | ||||||
DOI: | 10.1302/0301-620x.103b5.bjj-2020-1839.r1 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 25 February 2022 | ||||||
Date of first compliant Open Access: | 25 February 2022 | ||||||
RIOXX Funder/Project Grant: |
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