Journal article
The Trends in Treatment of Femoral Neck Fractures in the Medicare Population from 1991 to 2008
Journal of bone and joint surgery. American volume, Vol.95(18), pp.e132-e132
09/18/2013
DOI: 10.2106/JBJS.L.01163
PMCID: PMC3763808
PMID: 24048563
Abstract
BACKGROUND:We examined trends in the treatment of femoral neck fractures over the last two decades.\nMETHODS:We used Medicare Part A administrative data to identify patients hospitalized for closed femoral neck fracture from 1991 to 2008. We used codes from the International Classification of Diseases, Ninth Revision, to categorize treatment as nonoperative, internal fixation, hemiarthroplasty, and total hip arthroplasty. We examined differences in treatment according to hospital hip fracture volume, hospital location (rural or urban), and teaching status.\nRESULTS:Our sample consisted of 1,119,423 patients with intracapsular hip fractures occurring from 1991 to 2008. We found a generally stable trend over time in the percentage of patients managed with nonoperative treatment, internal fixation, hemiarthroplasty, and total hip arthroplasty. We found little difference in surgical treatment across different groups of hospitals (high volume compared with low volume, urban compared with rural, and teaching compared with nonteaching). The percentage of acute care hospitals treating hip fractures remained fairly constant (74.8% in 1991 to 1993 and 69.0% in 2006 to 2008). The median number of hip fractures treated per hospital did not change (thirty-three in 1991 to 1993 and thirty-three in 2006 to 2008). There was no increase in the percentage of fractures treated in high-volume hospitals over time (57.7% in 1991 to 1993 and 57.1% in 2006 to 2008) and little reduction in the percentage of fractures treated in low-volume hospitals (5.8% in 1991 to 1993 and 5.5% in 2006 to 2008).\nCONCLUSIONS:There has been little change in the trends of operative and nonoperative treatment for proximal femoral fractures over the last two decades, and there was little evidence of regionalization of hip fracture treatment to higher-volume hospitals.
Details
- Title: Subtitle
- The Trends in Treatment of Femoral Neck Fractures in the Medicare Population from 1991 to 2008
- Creators
- Benjamin Miller - Departments of Orthopaedics and Rehabilitation (B.J.M.) and Internal Medicine (X.L, P.C.), 200 Hawkins Drive, 01025 JPP, Iowa City, IA 52242. E-mail address for B.J. Miller: benjamin-j-miller@uiowa.eduXin Lu - Departments of Orthopaedics and Rehabilitation (B.J.M.) and Internal Medicine (X.L, P.C.), 200 Hawkins Drive, 01025 JPP, Iowa City, IA 52242. E-mail address for B.J. Miller: benjamin-j-miller@uiowa.eduPeter Cram - Departments of Orthopaedics and Rehabilitation (B.J.M.) and Internal Medicine (X.L, P.C.), 200 Hawkins Drive, 01025 JPP, Iowa City, IA 52242. E-mail address for B.J. Miller: benjamin-j-miller@uiowa.edu
- Resource Type
- Journal article
- Publication Details
- Journal of bone and joint surgery. American volume, Vol.95(18), pp.e132-e132
- DOI
- 10.2106/JBJS.L.01163
- PMID
- 24048563
- PMCID
- PMC3763808
- NLM abbreviation
- J Bone Joint Surg Am
- ISSN
- 0021-9355
- eISSN
- 1535-1386
- Publisher
- Journal of Bone and Joint Surgery Incorporated
- Language
- English
- Date published
- 09/18/2013
- Academic Unit
- Orthopedics and Rehabilitation; Internal Medicine
- Record Identifier
- 9984040212402771
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