ArticleBMJ open2021
Patient-related healthcare disparities in the quality of acute hip fracture care: a 10-year nationwide population-based cohort study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Quality indicators for structure and process in peri-operative care: a systematic review.Anaesthesia · 2026Pooled it
- Disparities in Antiemetic Prophylaxis Care Processes Predicted by Patient Neighborhood: Retrospective Cohort and Geospatial Analysis.JMIR public health and surveillance · 2026Article
- Temporal trends in socioeconomic inequalities and risk of infection after hip fracture surgery: a nationwide cohort study, 2010-2021.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Article
- Unsupervised clustering analysis of trauma/non-trauma centers using hospital features including surgical care.PloS one · 2024Article
- Economic evaluation of the prevention of falls resulting from missed care in polish hospitals.Frontiers in public health · 2024Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo characterise and quantify possible patient-related disparities in hip fracture care including temporal changes.
designPopulation-based cohort study.
settingAll Danish hospitals treating patients with hip fracture.
participants60 275 hip fracture patients from 2007 to 2016.
interventionsQuality of care was defined as fulfilment of eligible care process measures for the individual patient recommended by an expert panel. Using yearly logistic regression models, we predicted the individual patient's probability for receiving high-quality care, resulting in a distribution of adjusted probabilities based on age, sex, comorbidity, fracture type, education, family mean income, migration status, cohabitation status, employment status, nursing home residence and type of municipality. Based on the distribution, we identified best-off patients (ie, the 10% of patients with the highest probability) and worst-off patients (ie, the 10% of patients with the lowest probability). We evaluated disparities in quality of care by measuring the distance in fulfilment of outcomes between the best-off and worst-off patients. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was fulfilment of all-or-none, defined as receiving all relevant process measures. Secondary outcomes were fulfilment of the individual process measures including preoperative optimisation, early surgery, early mobilisation, assessment of pain, basic mobility, nutritional risk and need for antiosteoporotic medication, fall prevention and a postdischarge rehabilitation programme.
resultsThe proportion of patients receiving high-quality care varied over time for both best-off and worst-off patients. The absolute difference in percentage points between the best-off and worst-off patients for receiving all-or-none of the eligible process measures was 12 (95% CI 6 to 18) in 2007 and 23 (95% CI 19 to 28) in 2016. Disparities were consistent for a range of care processes, including assessment of pain, mobilisation within 24 hours, assessment of need for antiosteoporotic medication and nutritional risk assessment.
conclusionsDisparity of care between best-off and worst-off patients remained substantial over time.
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