Baby boomer broken hips fixed sooner

Article published 11 September 2023

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Baby boomer broken hips fixed sooner

Breaking a hip happens to a lot of older people. The sooner it's fixed the better they'll walk, but standards were ... slipping.

Time can be the enemy when treating people who break their hip. Prompt surgery means less pain, hastens recovery and reduces time spent in hospital. With Australia ageing fast, baby boomer broken hips will benefit from raised time-to-surgery standards.

Yet as hip fracture surgery can only be performed at larger hospitals with suitable facilities, some people in regional and remote areas must be transferred over large distances. In 2022, 14 per cent of hip fracture patients had to be transferred from one hospital to another for their surgery, costing hours during which the broken hip can deteriorate.

Across Australia, there is stark variation in the average time to surgery for hip fracture, from 16 to 92 hours for all patients last year.

New standards

The recommended standard up until now was 48 hours. In 2022, the average time to surgery was 38 hours for non-transferred patients but 51 hours for transferred patients. Typically, transferred patients sustain their hip fracture in a regional, rural or remote area, far away from a hospital which can deal with it promptly.

However, just as exploding numbers of baby boomers reach the age at which the likelihood of hip fractures increases, the standard is set to improve with an updated Hip Fracture Clinical Care Standard, released today by the Australian Commission on Safety and Quality in Health Care. The new standard for 38 hours brings Australia in line with international practice.

Every year in Australia, 19,000 people fracture their hip, usually after a fall. Most hip fractures happen to people over 65 years and are often a life changing event.

Australia’s ageing population makes taking action on hip fracture more important than ever.

Hip fracture significantly increases an older person’s risk of death, with one in four people dying within twelve months after a hip fracture injury. Of those who survive, many lose their ability to live independently or to return to their former lifestyle.

The Australian Commission on Safety and Quality in Health Care’s Acting Chief Medical Officer, emergency physician Associate Professor Carolyn Hullick, said there was an urgent need for health services to offer better care for people with a hip fracture, using the framework in the updated standard.

“Anyone who has seen someone live through a hip fracture knows it’s much more than a broken bone. People with a hip fracture tend to be older, frail and more vulnerable, so it is critical the fracture is repaired quickly to reduce pain and get them on the road to recovery back to independence,” she said.

“The data is sobering, as an Australian with a hip fracture is almost four times more likely to die within a year than someone of the same age who isn’t injured. This has an immense personal toll on individuals and families, in addition to the burden on our health system of around $600 million each year.”

While some hospitals have substantially reduced their time-to-surgery, there is still marked variation. In 2022, the average time-to-surgery ranged from 16 to 92 hours, with the longest waiting times for people being transferred for surgery. Patients received surgery within 48 hours 78 per cent of the time.

One person’s experience

For 85-year-old Esperance resident Jill Bower, it was a relief to know she was in good hands when she arrived by ambulance at Esperance Hospital after fracturing her hip. Jill was transferred from the small coastal town to Fiona Stanley Hospital in Perth by the Royal Flying Doctor Service.

Jill, who slipped while having a quiet night at home watching a Fremantle Dockers footy match in late July, said she couldn’t fault the care she received from healthcare workers throughout her journey.

“The staff caring for me were all truly wonderful. At Esperance they gave me the nerve block in my groin for pain before they moved me, which was great.

“They got me up the day after surgery on a tall frame and I felt good. Later they changed me onto a four-wheel walker and had me walking up the hallways once a day, using the side rails to keep me moving”.


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