Rural, urban, and teaching hospital differences in hip fracture mortality.

Autor: Farley BJ; Central Michigan University, College of Medicine, Mt. Pleasant, MI, USA., Shear BM; Central Michigan University, College of Medicine, Mt. Pleasant, MI, USA., Lu V; Central Michigan University, College of Medicine, Mt. Pleasant, MI, USA., Walworth K; Central Michigan University, College of Medicine, Mt. Pleasant, MI, USA., Gray K; Central Michigan University, College of Medicine, Mt. Pleasant, MI, USA., Kirsch M; Central Michigan University, College of Medicine, Mt. Pleasant, MI, USA., Clements JM; Central Michigan University, College of Medicine, Mt. Pleasant, MI, USA.; Michigan State University, College of Human Medicine, Division of Public Health, Flint, MI, USA.
Jazyk: angličtina
Zdroj: Journal of orthopaedics [J Orthop] 2020 Sep 06; Vol. 21, pp. 453-458. Date of Electronic Publication: 2020 Sep 06 (Print Publication: 2020).
DOI: 10.1016/j.jor.2020.08.039
Abstrakt: Introduction: Hip fractures remain one of the most prevalent and deadly conditions afflicting those 65 years and older. For other health conditions (e.g. myocardial infarction), hospital location is associated with poorer health outcomes. To our knowledge, no study has investigated the relationship between hip fracture morality rate in the United States between urban and rural hospital settings.
Methods: A retrospective cohort study was conducted to examine differences in in-hospital mortality between groups treated in rural, urban-teaching, and urban-non-teaching hospitals, as well as public and private hospitals. Mortality rates were also compared for variances between surgical treatment, sex, insurance, patient location, race, and income. Discharge data was collected for 256,240 inpatient stays from the 2012 National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Results: Odds of mortality were 14.6% greater in rural hospital hip fracture patients compared to Urban/Non-Teaching centers (p < 0.05).
Conclusions: Results from this study lend support to necessitate further research investigating prospective barriers to care of those in rural settings. This may point to limitations in resources and trained medical and surgical specialists in rural hospitals and need for continued research to mitigate such findings.
Competing Interests: The authors report no conflicts of interest and no funding
(© 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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