Disparities in survival after hip fractures in Chile in patients above 60 years: the impact of the operating room management.

Background: Hip fractures among individuals aged 60 and older significantly impact health, leading to increased morbidity, dependency, and financial strain while also elevating mortality risks. Variation in trauma management across healthcare settings underscores the urgent need for comprehensive data analysis to improve patient outcomes. Methods: This study employs an observational design. It analysed national databases from 2012 to 2017 to assess hip fracture incidence and survival rates among Chileans aged 60 and older. It examined the impact of factors such as age, type of health insurance provider, access to surgical treatment, and hospital type on mortality rates, using Kaplan-Meier and Cox proportional hazards models. Findings: The incidence of hip fractures in Chile remained constant, with the majority of cases being managed in public healthcare institutions. Public hospitals had longer stays and less access to surgery than private hospitals. Key mortality factors included access to surgery, age, previous hospitalisations, and gender, with survival rates lower than the general population, especially among patients treated in public hospitals. Interpretation: The findings of this study highlight the crucial need for public health initiatives that prioritise operating room management to improve surgical access and ensure timely care for patients with hip fractures. These findings provide policymakers in Chile with valuable insights to improve healthcare delivery and suggest that similar evaluations could benefit other countries with comparable demographics, potentially leading to significant improvements in healthcare policy.