Achieving the hip fracture Best Practise Tariff during the COVID-19 pandemic

Area of Science:

• Geriatric Medicine
• Orthopedic Surgery
• Infectious Diseases

Background:

• The Best Practice Tariff (BPT) for hip fractures is linked to reduced mortality rates.
• The COVID-19 pandemic presented unprecedented challenges to healthcare systems globally.
• Understanding the pandemic's effect on adherence to established care pathways is crucial.

Purpose of the Study:

• To assess the impact of the COVID-19 pandemic on achieving the Best Practice Tariff for hip fracture patients.
• To compare outcomes for hip fracture patients who contracted COVID-19 versus those who did not during the pandemic.

Main Methods:

• Retrospective review of adult hip fracture admissions between March and June 2020.
• Data collected included patient demographics, place of residence, delirium assessment, and mobility.
• Analysis of adherence to all Best Practice Tariff criteria; COVID-19 diagnosis via RT-PCR.

Main Results:

• 178 patients (mean age 82.8 years) were included.
• 18 patients (10.1%) tested positive for COVID-19.
• 44.4% of COVID-19 positive patients failed to achieve BPT, compared to 22.5% of COVID-19 negative patients.

Conclusions:

• Hip fractures in patients with concurrent COVID-19 infection were more likely to fail BPT criteria.
• COVID-19 positive hip fracture patients experienced higher 30-day mortality rates compared to COVID-19 negative patients.
• The pandemic adversely affected the achievement of best practice standards in hip fracture care.