The REDUCE study (Work package 1) v1
Research type
Research Study
Full title
REducing unwarranted variation in the Delivery of high qUality hip fraCture services in England and Wales; the REDUCE study (Work package 1)
IRAS ID
273758
Contact name
Celia L Gregson
Contact email
Sponsor organisation
University of Bristol
Duration of Study in the UK
3 years, 5 months, 31 days
Research summary
Breaking a hip is a devastating injury to sustain. 80,000 older adults break (or fracture) a hip each year in the UK; 30% die within a year and many suffer from pain and reduced mobility. Despite national guidelines, how health services organise hip fracture care varies greatly across UK hospitals. Unfortunately, how people recover varies greatly too. Patients with broken hips are looked after by multi-disciplinary healthcare teams (surgeons, physiotherapists, anaesthetists and more). We know the ways these healthcare teams are organised varies considerably, as do the services they provide, and therefore the ‘access’ patients have to these services is highly variable. We think there are organisational factors responsible for unjust variation that may affect patient recovery after a broken hip, and we expect this variation will have health-cost implications. Finding out which parts of the hip fracture care pathway explain variation in patient outcomes will tell us what service changes are needed and help us to develop a new step-by-step guide to ensure consistent, high quality care is equally available to all.
Using large anonymised clinical datasets which have been collected systematically across England and Wales, we will be able to assess hip fracture services, including how care is delivered in emergency departments, on wards, in operating theatres, and during rehabilitation. Statistical analyses will identify which organisational factors explain variation in patient outcomes after hip fractures (e.g. death, length of hospital stay, hospital readmissions, osteoporosis treatment) and identify hospital care pathways that are associated with high-quality consistent patient outcomes. Cost analyses will calculate the costs from hip fractures which are attributable to different organisational factors. With our new system-wide understanding of hip fracture care we will develop an Implementation Toolkit in partnership with key national stakeholders, to overcome organisational barriers when implementing sustainable high-quality fracture services for patients.
REC name
London - City & East Research Ethics Committee
REC reference
20/LO/0101
Date of REC Opinion
22 Jan 2020
REC opinion
Favourable Opinion