Funding for better outcomes for elderly after hip surgery

Wednesday, 14 October 2020

With hip fracture posing a major risk of death in people over 50, a new study aims to establish evidence for improved discharge planning for elderly patients following hip surgery.

Distinguished Laureate Professor Rob Sanson-Fisher AO
Distinguished Laureate Professor Rob Sanson-Fisher AO aims to improve recovery following a broken hip

With hip fracture posing a major risk of death in people over 50, a new study aims to establish evidence for improved discharge planning for elderly patients following hip surgery.

Lead Researcher and renowned behavioural and public health expert, Distinguished Laureate Professor Rob Sanson-Fisher AO said recovery following a broken hip could be a long and incredibly difficult process.

“Of people aged over 50 with a hip fracture, one in three are at risk of dying within 12 months. In elderly patients this risk is five to eight-times higher within the first three months of fracture,” said Professor Sanson-Fisher.

“In addition to pain, a hip fracture can dramatically impact quality of life, with reduced mobility, reduced independence and reduced social engagement. Hip fractures can be the tipping point for elderly people to move into aged care facilities, and other conditions such as dementia can be exacerbated.”

Professor Sanson-Fisher said the Australian Hip Fracture Clinical Care Standard recommended all hip fracture patients receive an individualised written care plan, however only 24% of hospitals routinely provided written plans and their quality and content was variable.

“When a patient is discharged after hospitalisation for hip fracture they need to take medication, visit their GP and are likely to require help to achieve a range of tasks. We want to look closely at an individual’s needs and tailor a detailed plan especially for them,” said Professor Sanson-Fisher.

“This individualised approach will be more costly initially, but we believe the savings will come later as patients will be less likely to require subsequent medical intervention.”

With NHMRC funding of close to half a million dollars, Professor Sanson-Fisher will lead a multi-disciplinary team of researchers from the University of Newcastle, the Hunter Medical Research Institute and Hunter New England Health.

This study, relying on a highly-skilled team of clinicians, geriatricians, health behavioural scientists, biostatisticians and health economists will investigate interventions to improve quality of life and reduce the likelihood of hospital readmissions for hip fracture patients.

A randomised controlled trial will test the health outcomes and cost-effectiveness of a multicomponent discharge package delivered to older people who have sustained a broken hip. Patients and their nominated support persons will be randomised to either usual care or a novel action-oriented discharge procedure.

The new approach to be tested will incorporate a discharge planning session with an orthogeriatric Advanced Trainee and a written Action Plan tailored to individual needs. A discharge letter will be sent to the patient’s general practitioner within 48 hours of discharge; and cues and reminders to promote adherence to the Action Plan will be provided.

The University’s Deputy Vice-Chancellor (Research & Innovation), Professor Janet Nelson, said this project to improve health and social outcomes for the elderly demonstrated the University’s commitment to helping people live better, healthier lives.

“Professor Sanson-Fisher and his team are highly regarded as experts in behavioural and public health and this NHMRC funding is a testament to their innovative and collaborative approach to addressing this key public health issue,” said Professor Nelson.

Assessments of the health outcomes of the tailored approach to discharge procedure will be obtained via self-report surveys 90 days after discharge. Cost-effectiveness of the approach will be assessed according to health care utilisations data from the Pharmaceutical Benefits Scheme (PBS), Medicare Benefits Scheme (MBS) and New South Wales Admitted Patients and Emergency Department Data Collection.

* HMRI is a partnership between the University of Newcastle, Hunter New England Health and the community.

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