Health inequality effects of the Best Practice Tariff for hip fracture
Research type
Research Study
Full title
Evaluating the health inequality effects of the Best Practice Tariff for hip fracture
IRAS ID
300674
Contact name
Susan Griffin
Contact email
Sponsor organisation
University of York
Duration of Study in the UK
0 years, 9 months, 31 days
Research summary
A broken hip, or hip fracture, is a serious injury that carries a risk of death and long-term pain and difficulty in moving around. Hip fractures require medical treatment, including surgery and follow-up care to aid recovery. After noticing big differences in the care delivered for similar injuries, the Department of Health changed how it paid hospitals in England for hip fracture care. Experts described what care would lead to the best outcomes for patients, and hospitals were paid for delivering these through a Best Practice Tariff.
We will check whether there are still differences in the care delivered between people, and we will compare this to the differences that existed before the Best Practice Tariff. We are particularly interested in any differences that are linked to people’s socioeconomic characteristics such as their income deprivation levels. This will let us summarise whether Best Practice Tariffs made care more equal between different types of people, for example between people living in poorer versus richer areas.
The information in the National Hip Fracture Database records the care delivered to people with hip fracture in England and Wales. Hospital records allow us to group people according to the general level of socioeconomic characteristics of people living in their local neighbourhoods. Best Practice Tariffs were introduced, only to English hospitals, in 2010 and were subsequently changed in 2017 to cover new elements. We will compare how care changed in Wales over time to how care changed in England over time to tell us what difference Best Practice Tariffs made to each socioeconomic group of people. We will then use knowledge of how best practice improves health outcomes and changes costs to describe the impact of Best Practice Tariffs on quality and length of life across the whole population.
REC name
London - Surrey Borders Research Ethics Committee
REC reference
21/LO/0565
Date of REC Opinion
29 Jul 2021
REC opinion
Favourable Opinion