Small and Medium Hospitals Yield More Hip Fracture Deaths

For anyone who has broken their hip or helped a loved one, you know that the recovery process is anything but enjoyable. Each year, in Canada alone, nearly 30,000 people experienced a hip fracture — that’s a lot of lives interpreted. Although the healing process can be painful, for some, they do not make it out of the hospital.

According to a new study, Canadians with broken hips are more likely to pass away after seeking medical treatment at a small or medium community hospital, in comparison to teaching or large hospitals. Shockingly, for every 1000 patients admitted with a hip fracture, 14 die within medium community hospitals and an additional 43 die in small community hospitals.

What’s Going On Here?

When you hear startling numbers such as those above, it’s hard not to wonder what’s going on. Why is it that so many more patients pass away within these smaller scale hospitals? As stated by a British Columbia associate professor, this study is not about blaming others — it’s more of a call to action.

Based on these new findings, it’s important that key factors are identified regarding improving care. Within this study, teaching hospitals are defined as those with members of the Association of Canadian Academic Healthcare Organizations; whereas community hospitals are defined by bed number, being broken down into categories — small, medium, and large.

More specifically, a small community hospital will have fewer than 50 beds; a medium hospital will offer between 50 and 199 beds; and lastly, a large hospital will offer more than 200 beds. Considering about 1 out of 10 hip fracture result in death, this accounts for approximately 3000 Canadians deaths.

Published in the Canadian Medical Association Journal, these findings focused on individuals who were 65 years and older, were admitted between the years 2004 and 2012, with a hip fracture not caused by a disease. Regarding teaching and large community hospitals, no difference was found.

Why Is There Such a Large Gap?

Although researchers did discover that more patients die from their injuries in small and medium community hospitals, they were not able to tell why. Although they didn’t examine key reasons, future research will focus on the impact of teaching, demand, volume and bed occupancy.

If they can identify key factors within the system of care, they would be able to advise further regarding potential improvements. What they did state, however, is that patients who underwent surgery were more likely to pass away in medium community hospitals. For every 1000 surgeries, there were 11 more deaths at medium hospitals.

It’s believed that with fewer beds, less equipment, and staff, it may be harder to ensure timely care. The time that it takes to transfer patients from small and medium community hospitals contributes to dangerous surgical delays. It’s also important to note that locations were not identified — only provinces.

Meaning, whether or not small and medium community hospitals tend to remote populations, wasn’t part of this analysis. Although smaller communities are likely to have smaller hospitals, it appears that these smaller facilities also exist across Canada’s urban areas as well. When aiming to prevent hip fractures, you can take proactive measures:

  • Ensure your home is safe — remove clutter, ensure there’s proper lighting, and install railings where needed.
  • Maintain an active lifestyle — even moderate exercise can help you improve muscle and bone strength. Balance training exercises are also recommended.
  • Better understand personal risk — have you ever had a bone density scan?
  • Eat a balanced diet — also be sure to get enough calcium and vitamin d.

If you are looking for more resources, you can find information on Bone and Joint Canada, as well as Osteoporosis Canada.

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