Abstract
Dr Foster, an independent health watchdog, has produced a national league table for hospital performance in hip fracture management. This was published in the Times newspaper in November 2001. No validation of the league table was presented and so we have compared the results of a prospective audit of our hip fractures with the data provided by Dr Foster.
A prospective audit of all patients admitted with hip fracture was undertaken over a 30-month period. An independent research assistant collected data on a standardised questionnaire. Data included basic demographics, comorbidities, mental test score, mobility and social status. Mortality data was obtained from the national office for statistics. Dr Foster’s data was obtained from the Hospital Episode Statistics and they also provided additional information on data and methodology.
Dr Foster reported that our hospital had a standardised mortality ratio of 107 and a one-year mortality per 100,000 population of 112.20. The hospital workload for the year 2000 was given as 400 hip fractures with 40 deaths (10%) within 30 days of surgery. Our prospective audit showed that 738 hip fractures were admitted in the year 2000. 677 were from the local population giving an incidence of hip fracture of 100.3 per 100,000. 63 of these patients died. Thus, the one-year mortality per 100,000 population is 63. The 30-day mortality for all patients admitted during the year was 9.3%.
The league table produced by Dr Foster is based upon inaccurate date. The workload error was 46% with a 10% error for mortality and a 56% error for population mortality statistics. It is completely unacceptable that such data should be published in the public domain without validation.
The abstracts were prepared by Mr Richard Buxton. Correspondence should be addressed to him at Bankton Cottage, 21 Bankton Park, Kingskettle, Cupar, Fife KY15 7PY, United Kingdom
