The Incidence of Hip Fractures in Long-Term Care Homes in Saskatchewan from 2008 to 2012: an Analysis of Provincial Administrative Databases

Authors

  • Lilian U. Thorpe University of Saskatchewan
  • Susan J. Whiting College of Pharmacy and Nutrition, University of Saskatchewan
  • Wenbin Li Saskatchewan Health Quality Council
  • William Dust Division of Orthopedic Surgery, Surgery, College of Medicine, University of Saskatchewan
  • Thomas Hadjistavropoulos Department of Psychology, University of Regina
  • Gary Teare Saskatchewan Health Quality Council

DOI:

https://doi.org/10.5770/cgj.20.273

Keywords:

hip fractures, long-term care, administrative databases

Abstract

Background

Hip fractures (HFs) represent an important cause of morbidity and mortality among adults in long-term care (LTC), but lack of detailed epidemiological data poses challenges to intervention planning. We aimed to determine the incidence of HFs among permanent LTC residents in Saskatchewan between 2008 and 2012, using linked, provincial administrative health databases, exploring associations between outcomes and basic individual and institutional characteristics.

Methods

We utilized the Ministry of Health databases to select HF cases based on ICD 10 diagnoses fracture of head and neck of femur, pertrochanteric fracture and subtrochanteric fracture of femur. HF incidence rates in LTC were compared to older adults in the general population.

Results

LTC residents were more likely to be female overall (65.5%), although this varied by age, with only 46.6% female in those under 65, but 77% female among those 90 years and older. Mean age of residents was highest in rural centres (85.2 yrs) and lowest in medium–large centres (81.0 yrs). Of 6,230 cases of HFs in the province during the study period, 2,743 (44%) were in the LTC cohort. Incidence rates per 1,000 person years increased with age and were higher in the LTC group (F = 68.6, M = 49.8) than the overall population (F = 1.62, M = 0.73). Rates of HFs in the province and in LTC were higher in females than males in all age groups, except for the youngest (< 65 years), where males had higher rates, and the oldest category (90+) where rates were similar. Women 90+ years in larger LTC had significantly higher (p = .035) HF rates than those in smaller LTC, and also had significantly (p = .001) higher rates in medium-large compared to smaller population centres. However, after age standardization to the overall SK population, it was apparent that the larger LTC facilities and the medium-large population centres had overall lower HF rates than the small and medium LTC facilities and the small urban and rural PCs, respectively. One health region had particularly high rates, even when accounting for age and sex composition.

Conclusion

Both HF numbers and incidence rates were higher in LTC compared to the overall population, with higher rates in older women, small to medium size LTC, and particular health regions. Our data suggest the need for further exploration of potentially remediable factors for HFs in smaller LTCs, and for targeting specific facilities and regions with outlying HF rates.

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Published

2017-09-29

How to Cite

1.
Thorpe LU, Whiting SJ, Li W, Dust W, Hadjistavropoulos T, Teare G. The Incidence of Hip Fractures in Long-Term Care Homes in Saskatchewan from 2008 to 2012: an Analysis of Provincial Administrative Databases. Can Geriatr J [Internet]. 2017 Sep. 29 [cited 2024 Mar. 29];20(3):97-104. Available from: https://cgjonline.ca/index.php/cgj/article/view/273

Issue

Section

Original Research