Comparing the dangers of a stay in English and German hospitals for high‐need patients

Friebel, Rocco; Henschke, Cornelia; Maynou, Laia

doi:10.1111/1475-6773.13712

Cited by 4 publications

(2 citation statements)

References 45 publications

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“…The revised MCD captures 'Date/time of discharge from acute care', but the degree to which extended care (beyond surgical management and the immediate postoperative period) is delivered in the acute hospital varies enormously around the world. [3][4][5][6][7][8][9] The introduction of a new optional field of 'Date/time of discharge from post-acute care' would allow subsequent recovery and rehabilitation to be captured. Different countries may need to adapt the precise definition to ensure that they most accurately profile the key elements of the pathway, which should be considered as 'Total time in orthopaedic/geriatric ward(s) on an acute hospital site' and 'Subsequent recovery and rehabilitation in a healthcare setting other than the patient's prefracture residence'.…”

Section: Discussionmentioning

confidence: 99%

“…1 Mortality in the first few weeks after the injury is of the order of 10%, and less than half of patients regain their previous abilities and independence. 2 A series of recent papers used hip fracture as a model of a 'high need, high cost' patient for health services in different countries, [3][4][5][6][7][8][9] and examined how mortality, length of stay, readmissions, and costs vary between nations. However, such use of administrative datasets is of limited use to clinicians, as it does not profile the details of the care provided to individual patients, or consider how different approaches to management might impact outcome.…”

Section: Introductionmentioning

confidence: 99%

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Developing a minimum common dataset for hip fracture audit to help countries set up national audits that can support international comparisons

Johansen

Ojeda-Thies

Poacher

et al. 2022

The Bone & Joint Journal

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Aims The aim of this study was to explore current use of the Global Fragility Fracture Network (FFN) Minimum Common Dataset (MCD) within established national hip fracture registries, and to propose a revised MCD to enable international benchmarking for hip fracture care. Methods We compared all ten established national hip fracture registries: England, Wales, and Northern Ireland; Scotland; Australia and New Zealand; Republic of Ireland; Germany; the Netherlands; Sweden; Norway; Denmark; and Spain. We tabulated all questions included in each registry, and cross-referenced them against the 32 questions of the MCD dataset. Having identified those questions consistently used in the majority of national audits, and which additional fields were used less commonly, we then used consensus methods to establish a revised MCD. Results A total of 215 unique questions were used across the ten registries. Only 72 (34%) were used in more than one national audit, and only 32 (15%) by more than half of audits. Only one registry used all 32 questions from the 2014 MCD, and five questions were only collected by a single registry. Only 21 of the 32 questions in the MCD were used in the majority of national audits. Only three fields (anaesthetic grade, operation, and date/time of surgery) were used by all ten established audits. We presented these findings at the Asia-Pacific FFN meeting, and used an online questionnaire to capture feedback from expert clinicians from different countries. A draft revision of the MCD was then presented to all 95 nations represented at the Global FFN conference in September 2021, with online feedback again used to finalize the revised MCD. Conclusion The revised MCD will help aspirant nations establish new registry programmes, facilitate the integration of novel analytic techniques and greater multinational collaboration, and serve as an internationally-accepted standard for monitoring and improving hip fracture services. Cite this article: Bone Joint J 2022;104-B(6):721–728.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Developing a minimum common dataset for hip fracture audit to help countries set up national audits that can support international comparisons

Johansen

Ojeda-Thies

Poacher

et al. 2022

The Bone & Joint Journal

View full text Add to dashboard Cite

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Healthcare Resource Utilization After Surgical Treatment of Cancer: Value of Minimally Invasive Surgery

et al. 2022

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Background As the US healthcare system moves towards value-based care, hospitals have increased efforts to improve quality and reduce unnecessary resource use. Surgery is one of the most resource-intensive areas of healthcare and we aim to compare health resource utilization between open and minimally invasive cancer procedures. Methods We retrospectively analyzed cancer patients who underwent colon resection, rectal resection, lobectomy, or radical nephrectomy within the Premier hospital database between 2014 and 2019. Study outcomes included length of stay (LOS), discharge status, reoperation, and 30-day readmission. The open surgical approach was compared to minimally invasive approach (MIS), with subgroup analysis of laparoscopic/video-assisted thoracoscopic surgery (LAP/VATS) and robotic (RS) approaches, using inverse probability of treatment weighting. Results MIS patients had shorter LOS compared to open approach: − 1.87 days for lobectomy, − 1.34 days for colon resection, − 0.47 days for rectal resection, and − 1.21 days for radical nephrectomy (all p < .001). All MIS procedures except for rectal resection are associated with higher discharge to home rates and lower reoperation and readmission rates. Within MIS, robotic approach was further associated with shorter LOS than LAP/VATS: − 0.13 days for lobectomy, − 0.28 days for colon resection, − 0.67 days for rectal resection, and − 0.33 days for radical nephrectomy (all p < .05) and with equivalent readmission rates. Conclusion Our data demonstrate a significant shorter LOS, higher discharge to home rate, and lower rates of reoperation and readmission for MIS as compared to open procedures in patients with lung, kidney, and colorectal cancer. Patients who underwent robotic procedures had further reductions in LOS compare to laparoscopic/video-assisted thoracoscopic approach, while the reductions in LOS did not lead to increased rates of readmission.

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