Hip Fractures in Chile: Implications for Public Health Policy and Healthcare Delivery

Hip fractures in individuals aged 60 and above pose significant challenges in terms of morbidity, mortality, and healthcare costs. While countries like the United Kingdom and Australia have optimized their healthcare systems for timely management of hip fractures, the situation in Chile presents distinct challenges due to its mixed healthcare system. This study aims to assess survival rates following hip fractures in Chile and identify associated risk factors using national databases from 2012 to 2018. A comprehensive analysis of 35,520 patients revealed that factors such as age, type of health insurance, access to surgery, and treatment in public hospitals significantly influence mortality rates after hip fractures. The study found that patients with hip fractures experience lower 5-year survival rates compared to the general population, particularly when affiliated with public insurance and treated in public institutions. Modifiable factors like delayed surgery and prolonged hospital stays contribute to increased mortality rates. The findings underscore the urgent need for optimized public health policies and healthcare delivery systems to enhance outcomes for hip fracture patients in Chile.Hip fractures in individuals aged 60 and above pose significant challenges in terms of morbidity, mortality, and healthcare costs. While countries like the United Kingdom and Australia have optimized their healthcare systems for timely management of hip fractures, the situation in Chile presents distinct challenges due to its mixed healthcare system. This study aims to assess survival rates following hip fractures in Chile and identify associated risk factors using national databases from 2012 to 2018.

Study Overview

• Status: Completed
• Conditions: Hip Fractures
• Intervention / Treatment: Procedure: Access to surgery; Other: type of intitution

• Study Type: Observational
• Enrollment (Actual): 46380

Contacts and Locations

Study Locations

• Chile
  • Region Metropolitana
    • Santiago, Region Metropolitana, Chile, 8380456
      • Hospital Clínico Universidad de Chile

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The chilean national database of hospital discharge and the chilean death registry from 2012 to 2018 were used. , The date of death was recorded for the 35,520 patients who had deceased; otherwise, they are classified as alive as of the current date. We remark that the national discharge and death databases use the same patient IDs, and therefore, we can easily identify those patients who have died during the period under analysis. We notice that we have used the hospital discharge database up to 2017 to have at least one year of follow-up for patients after a hip fracture.

Description

Inclusion Criteria:

All patients in the national database between 2012 and 2017 which his principal was hip fracture. Diagnoses are classified using the International Classification of Diseases, 10th Revision (ICD-10) codes. A search was conducted for codes S72.0 (head and neck fracture of the femur), S72.1 (pertrochanteric fracture), and S72.2 (subtrochanteric fracture of the femur).

Exclusion Criteria:

missing IDs ID with inconsistent socio-demographic information. Patients with primary diagnosis of hip fracture that underwent surgery but the national code surgery was not one of the following: : 2104128, 2104129, 2104131, 2104132, 2104135, 2104228, 2104229 and 2104231

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
hip fracture; patients that were diagnosed with a hip fracture between 2012 and 2017	Procedure: Access to surgery; access to surgery after hip fracture; Other: type of intitution; public or private health care facility

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
survival after hip fracture	survival after hip fracture	one to five years after the hip fracture

Collaborators and Investigators

• Sponsor: University of Chile
• Collaborators: Instituto Sistemas Complejos de Ingeniería, Universidad de Chile, Santiago, Chile
• Investigators: Study Chair: Susana Mondschein, PhD, University of Chile

Study record dates

Study Major Dates

• Study Start (Actual): March 10, 2023
• Primary Completion (Actual): March 10, 2023
• Study Completion (Actual): January 30, 2024

Study Registration Dates

• First Submitted: February 12, 2024
• First Submitted That Met QC Criteria: February 12, 2024
• First Posted (Actual): February 20, 2024

Study Record Updates

• Last Update Posted (Actual): February 20, 2024
• Last Update Submitted That Met QC Criteria: February 12, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Wounds and Injuries; Leg Injuries; Femoral Fractures; Hip Injuries; Fractures, Bone; Hip Fractures
• Other Study ID Numbers: 101 (Other Identifier: Hamilton Integrated Research Ethics Board)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Both National regestries are free access, nevertheless, the raw data will be made available after publication.
• IPD Sharing Time Frame: after publication, until 10 years.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No