ArticleDeutsches Arzteblatt international2008
Guidelines or state civil codes in the management of femoral neck fracture? An analysis of the reality of care provision in North Rhine-Westphalia.
Article in Deutsches Arzteblatt international, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 14 citations in OpenAlex.
- [Femoral neck fractures].Orthopadie (Heidelberg, Germany) · 2023Article
- Treatment of Traumatic Femoral Neck Fractures with an Intramedullary Nail in Osteoporotic Bones.Indian journal of orthopaedics · 2021Article
- [One-year outcomes for proximal femoral fractures: Posthospital analysis of mortality and care levels based on health insurance data].Der Unfallchirurg · 2015Article
- [Hip fracture prosthetics in German trauma surgery. State of the art].Der Unfallchirurg · 2015Article
- [More patients in a shorter inpatient stay with better outcome in treatment of femoral neck fracture: external quality assurance in Westfalia-Lippe on 50,354 patients].Der Unfallchirurg · 2014Article
- Mortality after proximal femur fracture with a delay of surgery of more than 48 h.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2014Article
- [Medial femoral neck fractures: possible reasons for delayed surgery. Part 2: Results of data from external inpatient quality assurance within the framework of secondary data evaluation].Der Unfallchirurg · 2014Article
- [The influence of timing of surgery on mortality and early complications in femoral neck fractures, by surgical procedure: an analysis of 22,566 cases from the German External Quality Assurance Program].Der Unfallchirurg · 2013Article
- [Optimal timing of operations to treat fractures of the femoral neck with endoprotheses : CRP as a parameter of postoperative immunologic reaction].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2011Article
- [Quality assurance using routine data. Is outcome quality now measurable?].Der Unfallchirurg · 2010Article
- Fractured neck of femur--internal fixation versus arthroplasty.Deutsches Arzteblatt international · 2010Review
- [Medial hip neck fracture: influence of pre-operative delay on the quality of outcome. Results of data from the external in-hospital quality assurance within the framework of secondary data analysis].Der Unfallchirurg · 2010Article
- Numerical parameters and quality indicators in a medical emergency department.Deutsches Arzteblatt international · 2010Article
- Long-term results after over 17 years - Intramedullary gliding nail as treatment for traumatic femoral neck fractures.Journal of orthopaedicsArticle
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4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThis study analyzes healthcare management patterns in the German Federal State of North Rhine-Westphalia, with regard to time-to-surgery and operative technique in the management of femoral neck fracture.
methodsAnalysis of external quality assurance data relating to inpatient episodes of femoral neck fracture for North Rhine-Westphalia in the years 2004 and 2005. The study included data on 19 767 patients.
resultsMore than half of patients receive surgery within 24 hours of hospital admission. Large regional differences exist in relation to the type and timing of surgery. Day of the week is a key determinant of the timing of surgery. Even younger patients, in whom the hip joint should be preserved, receive delayed surgery in some regions. DISCUSSION: Structured dialog with individual hospitals revealed the following causes for the differences in care provision: guideline recommendations and the recommendations of the Federal Office for Quality Assurance ltd. (Bundesgeschäftsstelle Qualitätssicherung, BQS GmbH), are not accepted as the basis for practice in all quarters; in some areas the necessary staff to ensure timely surgery are lacking. This situation cannot be defended to a wider public, given the clear indications from international literature that a short time to surgery reduces postoperative mortality as well as the incidence of key complications, such as pressure sores, thromboembolisms and pneumonia.
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