Variation in surgical demand and time to hip fracture repair: a Canadian database study
| Autor: | Katie J, Sheehan, Boris, Sobolev, Pierre, Guy, Jason D, Kim, Lisa, Kuramoto, Lauren, Beaupre, Adrian R, Levy, Suzanne N, Morin, Jason M, Sutherland, Edward J, Harvey, James, Waddell |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Canada Databases Factual Hip fracture surgery Variation Time-to-Treatment Hip fracture 03 medical and health sciences 0302 clinical medicine Demand Medicine Humans 030212 general & internal medicine Hip fracture repair Aged Aged 80 and over business.industry Hip Fractures 030503 health policy & services Health Policy lcsh:Public aspects of medicine Database study Surgical delay lcsh:RA1-1270 medicine.disease Confidence interval Patient Discharge Surgery Clearance time Hospitalization Benchmarking Median time Surgical Procedures Operative Female Time to surgery 0305 other medical science business Research Article |
| Zdroj: | BMC Health Services Research BMC Health Services Research, Vol 20, Iss 1, Pp 1-10 (2020) |
| DOI: | 10.14288/1.0394741 |
| Popis: | Background Competing demands for operative resources may affect time to hip fracture surgery. We sought to determine the time to hip fracture surgery by variation in demand in Canadian hospitals. Methods We obtained discharge abstracts of 151,952 patients aged 65 years or older who underwent surgery for a hip fracture between January, 2004 and December, 2012 in nine Canadian provinces. We compared median time to surgery (in days) when demand could be met within a two-day benchmark and when demand required more days, i.e. clearance time, to provide surgery, overall and stratified by presence of medical reasons for delay. Results For persons admitted when demand corresponded to a 2-day clearance time, 68% of patients underwent surgery within the 2-day benchmark. When demand corresponded to a clearance time of one week, 51% of patients underwent surgery within 2 days. Compared to demand that could be served within the two-day benchmark, adjusted median time to surgery was 5.1% (95% confidence interval [CI] 4.1–6.1), 12.2% (95% CI 10.3–14.2), and 22.0% (95% CI 17.7–26.2) longer, when demand required 4, 6, and 7 or more days to clear the backlog, respectively. After adjustment, delays in median time to surgery were similar for those with and without medical reasons for delay. Conclusion Increases in demand for operative resources were associated with dose-response increases in the time needed for half of hip fracture patients to undergo surgery. Such delays may be mitigated through better anticipation of day-to-day supply and demand and increased response capability. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|