HIP FRACTURE INCIDENCE AND MORTALITY IN AN ENGLISH REGION - A STUDY USING ROUTINE NATIONAL-HEALTH-SERVICE DATA

Background We investigated the validity of routine hospital and mortal ity hip fracture data in one English Region and estimated trends in hi p fracture between 1978-1981 and 1993-1995. Methods We identified from Hospital Episode System (HES) data for 1993-1995 all hip fracture epi sodes relating to individual patients aged over 65 years resident in W essex. We determined from the discharge method code whether an individ ual had died during that admission. The number of individual regional and district admissions and deaths were compared with those presented in the Public Health Common Data Set. We compared regional admission r ates with data for 1978-1981 from a previous study. Results National c omparative indicators for hip fracture overestimated individual admiss ions in Wessex by 17 per cent (in health authorities by 1-56 per cent) . National comparative indicators for hip fracture mortality underesti mated individual deaths in Wessex by 48 per cent. Between 1978-1981 an d 1993-1995 the age-sex-standardized hip fracture rates rose from 1.90 to 2.63 per 1000 per year for men and from 5.70 to 7.70 per 1000 per year for women. Rates increased in all age groups except those aged 65 -69 years. There was also a small fall in absolute mean annual numbers in this age group. The rates also fell in females aged 70-74. Conclus ions It is possible to adjust routine national HES data to take accoun t of multiple episodes within a single admission. These methods should be applied to national comparative indicators for hip fracture admiss ion and deaths. Hip fracture rates continue to rise in those aged over 70 years. There may be a cohort effect with those born after 1925 sho wing stable rates which needs further investigation.