Emergency hospital admissions for fracture neck of femur, indirectly age standardised ratio, 65 years and over, persons.
Rationale
Hip fracture is a debilitating condition. Only one in three sufferers return to their former levels of independence and one in three ends up leaving their own home and moving to long-term care. Hip fractures are almost as common and costly as strokes, and the incidence is rising. In the UK, about 75,000 hip fractures occur annually at an estimated health and social cost of about £2 billion a year. The National Institute for Health and Clinical Excellence (NICE) has projected the incidence to increase by 34% in 2020, with an associated increase in annual expenditure (NICE Guideline last accessed 12/04/2017). The average age of a person with hip fracture is about 83 years, and about 73 percent of fractures occur in women. There is a high prevalence of comorbidity in people with hip fracture (NHFD Report 2013). The National Hip Fracture Database reports that mortality from hip fracture is high, about one in ten people with a hip fracture die within 1 month and about one in three within 12 months. NICE has produced a quality standard that covers the management and secondary prevention of hip fracture in adults (18 years and older). The standard is designed to drive measurable improvements in the three dimensions of quality: patient safety, patient experience, and clinical effectiveness for fragility, fracture of the hip, or fracture of the hip due to osteoporosis or osteopenia.
Definition of numerator
Emergency admissions with an admission method (ADMIMETH in list '21', '22', '23', '24', '25', '28', '2A','2B', '2C', '2D); defined by a primary diagnosis (ICD10) code of S720, S721 or S722 and patient classification 'ordinary' (1 or 2), episode status is equal to 3, epiorder is equal to 1. These values have not been published due to disclosure control (see 'Disclosure control' section for further details).
Definition of denominator
Applying the reference (England) age specific rates to the registered local population to give number of expected admissions. These values have not been published due to disclosure control (see 'Disclosure control' section for further details).
Caveats
NHS Digital has identified a data quality issue affecting HES data for Nottingham University Hospitals Trust (NUH) in the financial year 2016 to 2017. Over 30 percent of records from this trust did not have a valid geography of residence assigned. PHE have flagged the areas affected by this issue as the values should be treated with caution. For more details, see: NHS Digital