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 Name
 In-Hospital Hip Fracture in Elderly (65+) Patients
 Short/Other Names
 In-Hospital Hip Fracture (65+)
 Description
 This indicator measures the rate of in-hospital hip fractures among acute care inpatients age 65 and older. For further details, please see the General Methodology Notes.
 Interpretation
 Lower rates are desirable.
 HSP Framework Dimension
 Health System Outputs: Safe
 Areas of Need
 Getting Better
 Geographic Coverage
 All provinces/territories except Quebec
 Reporting Level/Disaggregation
 National, Province/Territory, Region, Facility, Peer Group
 Indicator Results
 https://www.cihi.ca/en/cihi-health-indicators
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Identifying Information
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 Name
 In-Hospital Hip Fracture in Elderly (65+) Patients
 Short/Other Names
 In-Hospital Hip Fracture (65+)
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Indicator Description and Calculation
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 Description
 This indicator measures the rate of in-hospital hip fractures among acute care inpatients age 65 and older. For further details, please see the General Methodology Notes.
 Calculation: Description
 The indicator is expressed as a rate of in-hospital hip fractures per 1,000 inpatient cases. Risk-adjusted rate = Observed cases ÷ Expected cases × Canadian average Unit of analysis: Single admission
 Calculation: Geographic Assignment
 Place of service
 Calculation: Type of Measurement
 Rate - per 1,000
 The following covariates are used in risk adjustment: For a detailed list of covariates used in the model, please refer to the Model Specification document.
 Calculation: Method of Adjustment
 Poisson regression
 Denominator
 Description: Acute care discharges of patients age 65 and older Inclusions: 1. Admission to an acute care institution (Facility Type Code = 1) 2. Age at admission 65 years and older 3. Sex recorded as male or female Exclusions: 1. Records with admission category of cadaveric donor or stillbirth (Admission Category Code = R or S)
 Numerator
 Description: Cases within the denominator with a post-admission hip fracture Inclusions: 1. One of the following ICD-10-CA codes, coded as type 2: Fracture of neck of femur (S72.0) Intertrochanteric fracture (S72.10) Unspecified trochanteric fracture (S72.19) Subtrochanteric fracture (S72.2) Exclusions: 1. Other specified misadventures during surgical and medical care (one of the above S codes and Y65.8 coded as type 9) OR 2. Fracture of bone following insertion of orthopedic implant, joint prosthesis or bone plate (M96.6 coded as type 2 or T81.88 coded as type 2)
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Background, Interpretation and Benchmarks
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 Rationale
 In-hospital hip fractures are largely preventable and represent a patient safety concern. In addition to the profound impact hip fractures can have on the independence and quality of life of elderly patients, such injuries occurring within hospital are also associated with longer lengths of stay and increased health care costs. This indicator is intended to help hospitals monitor prevention efforts; high rates should be used to identify areas for improvement.
 Interpretation
 Lower rates are desirable.
 HSP Framework Dimension
 Health System Outputs: Safe
 Areas of Need
 Getting Better
 Targets/Benchmarks
 Not applicable
 References
 Corsinovi L, Bo M, Ricauda AN, et al. Predictors of falls and hospitalization outcomes in elderly patients admitted to an acute geriatric unit. Archives of Gerontology and Geriatrics. July 2009. Johal KS, Boulton C, Moran CG. Hip fractures after falls in hospital: A retrospective observational cohort study. Injury. February 2009. Oliver D, Daly F, Martin FC, McMurdo ME. Risk factors and risk assessment tools for falls in hospital in-patients: A systematic review. Age and Ageing. March 2004. Pulcins I, Wen E. In-hospital hip fractures in Canada: Using information to improve patient safety. Healthcare Quarterly. 2004. Salgado RI, Lord SR, Ehrlich F, Janji N, Rahman A. Predictors of falling in elderly hospital patients. Archives of Gerontology and Geriatrics. May 2004. Ziden L, Wenestam CG, Hansson-Scherman M. A life-breaking event: Early experiences of the consequences of a hip fracture for elderly people. Clinical Rehabilitation. September 2008.
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Availability of Data Sources and Results
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 Data Sources
 Available Data Years
 Type of Year: Fiscal First Available Year: 2012 Last Available Year: 2016
 Geographic Coverage
 All provinces/territories except Quebec
 Reporting Level/Disaggregation
 National, Province/Territory, Region, Facility, Peer Group
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 Update Frequency
 Every year
 Indicator Results
 Web Tool: CIHI Health Indicators URL: https://www.cihi.ca/en/cihi-health-indicators
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