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2012 HSR&D/QUERI National Conference Abstract

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2012 National Meeting

3063 — Temporal Trends in Incidence of Hip Fractures in VA Community Living Centers (CLCs)

Bulat T, and Campbell R, COE Tampa/VISN 8 PSCI; Powell-Cope G, COE Tampa;

To determine whether VA national patient safety initiatives (National Falls Toolkit and Hip Protector Toolkit Implementation) have impacted the incidence of hip fractures in VA community living centers (CLC).

The data were extracted from the hospital discharge datasets (Austin Information and Technology Center) for FY 2000 -2008. Fractures were identified using ICD-9-CM diagnosis codes (800 – 829) for the principal admitting diagnosis. The source of admission was limited to VA CLCs for the hip fracture trend analysis. A rate of hip fractures per bed days of care (BDOC) was calculated for each year.

The overall fracture trend analysis found that trends in the number of fracture discharges from VA hospitals have been fairly constant over FY 2000-2008. A little over 6,000 fractures discharges occurred annually. The source of admission for these fractures included all care settings (community, transfer from hospital, nursing home, etc.). The overall hip fracture incidence trend analysis found that trends in VA hospital hip fracture discharges (from all admission sources) have been decreasing over time. In FY2000, there were 2,671 hip fracture discharges, and by FY2008, 2,303 hip fracture discharges. The nursing home-based hip fractures admitted to VA hospital analysis found that the number of hip fractures admitted from VA CLC over this time frame have decreased 28%, from 160 a year in FY2000 to 116 in FY2008. There was a 19% decrease in the rate of hip fractures per 100,000 bed days of care in VA CLC between FY2000 and FY2008.

There was a distinct change in the rate of hip fractures starting in FY2005 when the patient safety initiatives were being implemented, and this downward trend has persisted relative to pre-FY2005 rates. Further analyses are needed to more accurately identify the impact of the patient safety initiatives in VHA.

This preliminary analysis establishes that there is a temporal relationship between the patient safety initiatives implementation in FY2005 and a subsequent improvement in the trend for nursing home hip fractures admitted to VA hospitals.

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