Outcomes of Hip Fractures at Teaching Hospitals Versus Non-Teaching Hospitals

Hip fractures in adults are associated with a large burden of suffering in the United States and are a major focus of various advocacy groups, professional organizations and government agencies. Strategies for prevention of hip fractures include primary prevention of osteoporosis, secondary prevention of fractures in patients with asymptomatic osteoporosis, tertiary prevention of complications in patients with hip fractures, and quarternary prevention of long-term disability from hip fracture. As a tertiary prevention option, surgery to repair a hip fracture has many benefits but is still associated with negative outcomes. This research establishes the evidence base and proposes a secondary analysis for determining whether patients treated for hip fracture at teaching hospitals experience fewer negative outcomes than do patients treated at non-teaching hospitals. A systematic review of the literature does not permit the drawing of firm conclusions about teaching hospital status, but a secondary analysis of data from the Nationwide Inpatient Sample (NIS) database could advance our understanding of the context of hip fracture outcomes. A study sample, based on patients with ICD-9 diagnosis codes for hip fracture, can be drawn from admissions represented in the NIS database, and outcomes including rates of mortality, rates of various postoperative complications, lengths of stay, cost, and discharge dispositions can be correlated with forms of treatment and teaching hospital status.Master of Public Healt