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No clinically meaningful differences found for femoral neck fracture care following health care reform
No clinically meaningful differences in hospital processes for femoral neck fracture care were found following the implementation of state health care reform initiative in Massachusetts, according to study results.
Researchers assessed the differences in hospital processes for fracture care and quality measures for the periods before (2003 to 2006) and after (2008 to 2010) health reform in Massachusetts via the Act Providing Access to Affordable, Quality, Accountable Health Care of 2006 among 23,485 patients treated for femoral neck fracture.
Andrew J. Schoenfeld
In the periods before and after health care reform, results showed no significant difference in the type of surgical intervention used to treat femoral neck fractures. Following health care reform, researchers found a significant decrease in length of stay from 6.6 days to a mean of 6 days. Researchers also found patients were less likely to be discharged home or to an extended care facility and more likely to be discharged to a skilled nursing facility after health care reform.
In-hospital mortality prior to health care reform was 3.9% and appreciated after reform, according to study results. However, results showed a decrease in the reoperation rate from 1.1% before the reform to 0.9% after the reform. Researchers also found a significant decrease in rate of failure to rescue after reform, but an increase in rate of complications.
“Although some differences in quality measures were noted, these cannot necessarily be attributed to health care reform,” the authors wrote. – by Casey Tingle
Disclosure: Schoenfeld was a Robert Wood Johnson Foundation Clinical Scholar at the University of Michigan at the time the study was conducted.