€280k paid to hospitals for hip procedures


Almost €280,000 was paid out in financial rewards to hospitals who treated older hip fracture patients in line with best practice last year.

St Vincent’s in Dublin was awarded €65,000 for meeting eight different standards of care when operating on hip fracture patients aged 60 and over.

Cork University Hospital (CUH) received the second largest reward of €51,000.

Despite the introduction of a best practice tariff (BPT) last year, where hospitals receive €1,000 per case that meets the BPT, only 7% of patients with a hip fracture received the best practice standard of care.

Two hospitals, Mayo University Hospital and University Hospital Kerry, did not receive any BPT payments in 2018.

The figures are contained in the Irish Hip Fracture Database National Report 2018, published today by the National Office of Clinical Audit.

Among the report’s key findings are:

Most patients (83%) with hip fracture are not admitted to an acute orthopaedic ward within four hours of presentation or brought directly to the theatre from the emergency department (ED) within four hours, as per best practice;

Almost three quarters (72%) of surgeries were conducted within 48 hours during normal working hours, as per best practice;

A geriatrician reviewed more than two thirds of patients at some point during their hospital stay, as per best practice;

A bone health assessment was carried out 84% of patients, up from 73% in 2017.

Of the 3,751 hip fracture cases recorded in 2018, 69% were female.

The home continues to be the place from which most patients are likely to be admitted and the mean length of stay for hip fracture patients was 18.7 days.

The report says there “continues to be a low rate of total hip replacements performed in Ireland” compared to international rates.

It says the number of orthopaedic surgeons with arthroplasty surgery skills (replacement or reconstruction of a joint) “should be examined at hospital level and hospital rosters should be planned to maximise the availability of that skillset for patients”.

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