ArticleJournal of bone and mineral metabolism2025
Three-year trends in early hip fracture surgery surrounding a national reimbursement policy in Japan.
Article in Journal of bone and mineral metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Optimizing treatment strategies for femoral neck fractures using a machine learning model.Journal of orthopaedic surgery and research · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionTimely surgical intervention for hip fractures is essential for improving outcomes in older adults. Japan's Ministry of Health, Labour and Welfare (MHLW) recently introduced a reimbursement policy to incentivize hip fracture surgery within 48 h. However, the impact and sustainability of this policy remain unclear. MATERIALS AND
methodsThis retrospective cohort study included 498 patients aged ≥ 75 years with hip fractures at a single Japanese hospital from 2022 (pre-policy) to 2024 (post-policy year 2). We performed univariate and multivariate logistic regression analyses of the rate of early surgery (≤ 48 h) to identify predictors of surgical delay.
resultsThe early surgery rate rose from 42.4% in 2022 to 52.7% in 2023 but declined to 45.1% in 2024. The reimbursement policy was associated with reduced surgical delay in its first year (2023; OR = 0.58, p = 0.024), but this effect was not sustained. Key structural and clinical predictors of delay included nursing home residence, refusal at other hospitals, weekend admission, and multi-specialty consultation. The frequency of off-hours surgery decreased in 2024, possibly due to the 'Workstyle Reform for Physicians' policy. Interaction analysis showed a suggestive inverse effect of off-hours surgery on delay.
conclusionJapan's reimbursement policy was initially effective, but its impact was transient and ultimately reversed by the competing national workstyle reform policy. Our findings underscore that to achieve sustained improvements in timely surgical care, future strategies must not only ensure coordinated policy design but also address persistent structural barriers, including weekend service gaps and fragmented regional coordination.
Indexed as
Identifiers
41032116What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.