England has highest hip fracture death rates in western world

England has the highest death rates for older people hospitalised with a hip fracture or heart failure in the western world.

Almost a third died in England a year after hip surgery

A year after their hip fracture surgery, almost a third (31 per cent) of patients in England had died, compared with 23 per cent in Canada, 22 per cent in Australia and a fifth in France, according to a new study.

The research, led by Harvard University and the London School of Economics, analysed medical records to compare the cost of care for different health systems in 11 countries, including the NHS in England.

The academics focused on pre-pandemic data from 2014/15 to 2017/18 for the International Collaborative on Costs, Outcomes and Needs in Care (ICCONIC) study.

Patients spent 21 days on average in English hospitals after surgery

High mortality among hip fracture patients occurred despite over 82 per cent of hip fracture patients in England having hip surgery within 48 hours of admission.

Patients in England spent an average of 21 days in hospital after their surgery – the highest of all 11 countries evaluated.

Countries such as the Netherlands, Sweden and Canada have been able to provide accessible post-hospital care for hip fracture rehabilitation in either community-based or short-term residential care settings, resulting in much shorter hospital stays than patients in England.

The study found death rates were also the highest in England for people hospitalised with heart failure who also have diabetes. While the NHS remains a low-cost health care system that performs well in some areas, the study found mortality rates for some patients are higher than in comparable countries – including in key areas such as cancer and cardiovascular disease.

Dr Irene Papanicolas, associate professor of Health Economics at the London School of Economics, said: “England stands out both because of the low cost with which it is able to provide care.

"However, England also has higher year-long mortality than other countries participating in the study. Further work is needed to understand what England can do to improve patient outcomes.”

Dr Jennifer Dixon, chief executive of the Health Foundation, which analysed the data, said: "The study suggests there is a significant opportunity to achieve higher quality care for patients, in part by learning from how other health systems deliver care and the investment it takes to do so.

"That patients in England with hip fracture spend far longer in hospital after surgery than they would in other countries also highlights an opportunity to improve efficiency by reducing the avoidable use of hospital care.

“Less avoidably long stays would mean existing capacity could be better used to address the backlogs in hospital care as a result of the pandemic. This could contribute to both better outcomes for patients and - as hip fracture is the most common reason for emergency surgery - significantly improved productivity for hospitals across the country.”