Hip fractures are common among elderly patients after a fall or a continuous decline in bone density due to the natural aging process. When a portion of a patient’s hip is damaged or diseased, hip replacement surgery is often the next viable step to return the individual to the quality of life they desire. Hip operations help alleviate pain for most patients, as well as offer greater mobility and better functioning of the hip joint for years into the future. However, some patients experience complications with hip surgeries, post-procedure, including infections at the surgical site, blood clots, and bone growth that extends past the natural edges of the hip. Combatting these issues is a challenge which is made ever more complex when delays in operations take place after a patient is admitted to the hospital.
Recently, the National Institute for Health and Clinical Excellence (NICE) updating the recommendation for patients in need of hip surgery, decreasing the time between hospital admission and surgery to within 24 hours instead of 48 hours. As it stands now, almost half of patients who are recommended to have a hip operation wait more than 36 hours before the procedure is performed, with some waiting several days to see the surgeon. The delay has resulted in fatalities occurring within 12 months after the operation, affecting as many as one in three patients who are admitted to the NHS. NICE and health care advocacy groups see this is a cause for concern for the tens of thousands of elderly patients who face the need for hip surgery throughout the UK each year.
Problems with Extended Wait Times
Although the intended outcome of a hip surgery is to restore range of motion in the hip joint as well as decrease pain associated with a fracture or deterioration of the bone, an extended wait time after uncovering a hip injury or illness often leaves patients without the potential to experience these benefits. Instead, patients may be re-admitted to the hospital when hip surgery is delayed, due to complications with recovery, infections, or other issues that put the patient at risk. Adding more strain on an already overwhelmed health system of physicians, nurses, and surgeons increases the total cost of care across the board, which ultimately leads to a perpetual cycle of lower quality care for all patients.
A representative from a leading medical negligence team in the UK states that reducing the wait times for hip operations has the potential to improve outcomes significantly for the elderly patient population. The recent study has the ability to impress upon health care providers and the NHS at large the necessity of performing hip surgeries within 24 hours after a patient has been admitted to the hospital, reducing complications and readmission over time. Given that the patient population is rapidly aging in the UK, healthcare providers have a responsibility to get ahead of this widespread issue to ensure all patients have access to the quality of care they need in a timely manner.
Implementing the Recommendations
While some health care providers have shared concern over the call for a reduction in hip surgery wait times, NICE published guidance on the issue that holds a great deal of promise. Currently, the NHS spends more than £2 billion each year on both social and medical care for patients who are admitted to the hospital with a hip injury or illness, based on the one in six UK residents who experience a hip issue each year. That equates to nearly 75,000 hip fractures diagnosed and subsequently treatment within the NHS on an annual basis – a number that is expected to rise in the coming years. While these costs may seem substantial to the untrained eye, the expenses associated with extending wait times are far greater.
NICE reported that implementing the updated recommendations for same-day hip surgeries would have no impact on the cost of care provided to elderly patients who are admitted to the hospital. Instead, earlier operations have the potential to decrease the total cost of care into the future. When same-day hip operations are performed, and the medical team works collaboratively to design and implement a care plan for patients shortly after surgery, patients have a much high chance of regaining mobility and their independence quickly post-operation. When these simple recommendations are put in place, a burden of readmittance to the hospital and ongoing social care for surgery patients is reduced, allowing older patients and their families to sustain a quality of life they want and deserve.