A Comparison of Geriatric Hip Fracture Databases

Area of Science:

• Trauma Surgery
• Quality Improvement Science
• Health Informatics

Background:

• The National Surgical Quality Improvement Project (NSQIP) and Trauma Quality Improvement Project (TQIP) collect data on geriatric hip fractures (GHFs).
• These datasets are intended for risk-adjusted quality metrics in GHF patient care.
• Differences between internal GHF data and external registries (NSQIP, TQIP) warrant investigation.

Purpose of the Study:

• To compare the completeness of GHF case identification between an institutional database and national quality registries (NSQIP, TQIP).
• To assess potential discrepancies in data capture for geriatric hip fracture patients.

Main Methods:

• A retrospective chart review of GHFs treated between January 1 and December 31, 2015.
• Comparison of patient data within an internal GHF database against NSQIP and TQIP reported cases.
• Analysis of differences in case identification and reported outcomes between the databases.

Main Results:

• An institutional database identified 96% of "true" GHFs, compared to 70% by NSQIP and 9% by TQIP.
• No significant differences were observed in patient outcomes or total costs between the databases.
• The NSQIP database reported a higher net revenue per patient ($24,373) compared to the institutional database.

Conclusions:

• Institutional databases appear more comprehensive for identifying geriatric hip fracture cases than NSQIP and TQIP.
• Caution is advised when utilizing NSQIP/TQIP data for evaluating the quality of care for GHFs due to potential undercounting.
• Further research may be needed to understand revenue discrepancies and improve data registry accuracy.