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Hip fracture care clinical care standard indicators: 6a-Proportion of patients with a hip fracture receiving bone protection medicine prior to separation from the hospital at which they underwent surgery

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this term Indicator 6a-Proportion of patients with a hip fracture receiving bone protection medicine prior to separation from the hospital at which they underwent surgery
METeOR identifier:Help on this term628253
Registration status:Help on this termHealth, Standard 12/09/2016
Description:Help on this term

Proportion of patients with a hip fracture receiving a prescription for, or were administered bone protection medicine prior to separation from the hospital at which they underwent hip fracture surgery.

Rationale:Help on this term

Hip fractures are most often secondary to a fall and are indicative of underlying osteoporosis. Bone protection medicine has been shown to reduce the risk of another fracture (Metcalfe 2008; ACSQHC 2009).

Indicator set:Help on this termClinical care standard indicators: hip fracture Health, Standard 12/09/2016
Australian Commission on Safety and Quality in Health Care, Superseded 18/06/2018
Outcome area:Help on this termMinimising risk of another fracture Health, Standard 12/09/2016

Collection and usage attributes

Computation description:Help on this term

The numerator includes patients with a hip fracture who receive bone protection medicine prior to separation from the hospital at which they underwent hip fracture surgery. Bone protection medicine can include (ANZHFR Steering Group 2013).

  • Bisphosphonates: alendronate (oral), risedronate (oral), zoledronate (intravenous) (with or without vitamin D and/or calcium where indicated).
  • Denosumab (with or without vitamin D and/or calcium where indicated).
  • Strontium ranelate (with or without vitamin D and/or calcium where indicated).
  • Teriparatide (with or without vitamin D and/or calcium where indicated).

Both the numerator and the denominator exclude episodes where Episode of admitted patient care—separation mode, code N=8 Died.

Presented as a percentage.

Computation:Help on this term

(Numerator ÷ denominator) x 100

Numerator:Help on this term

Number of patients with a hip fracture who receive a prescription for, or were administered bone protection medicine prior to separation from the hospital at which they underwent surgery for hip fracture.

Denominator:Help on this term

Number of patients with a hip fracture separated from the hospital at which they underwent surgery for hip fracture.

Comments:Help on this term

This indicator measures the proportion of patients receiving bone protection medicine upon separation from hospital, which has evidence of fracture risk reduction in patients with minimal trauma fracture. Many patients will also require vitamin D supplementation to correct vitamin D deficiency and to prevent hypocalcaemia due to the bone protection medicine. Some patients will also require calcium supplements if the recommended calcium intake cannot be achieved through diet (MJA 2013).

The expected result for this indicator is not 100%. Some patients may prefer not to take a bone protection medicine or may have contraindications. Vitamin D deficiency and hypocalcaemia must be corrected before commencing some bone protection medicines.

For hospitals collecting the Australian and New Zealand Hip Fracture Registry (ANZHFR) data set (ANZHFR Steering Group 2013), the variable Bone protection medication at discharge from acute hospital can be used for the numerator of this indicator.

Representational attributes

Representation class:Help on this termPercentage
Data type:Help on this termReal
Unit of measure:Help on this termService event
Format:Help on this term

N[NN]

Source and reference attributes

Submitting organisation:Help on this term

Australian Commission on Safety and Quality in Health Care

Reference documents:Help on this term

ACSQHC (Australian Commission on Safety and Quality in Health Care) 2009. Preventing falls and harm from falls in older people: best practice guidelines for Australian hospitals. Sydney: ACSQHC. Viewed 5 May 2016, www.safetyandquality.gov.au/wp-content/uploads/2012/01/Guidelines-HOSP1.pdf.

ANZHFR (Australian and New Zealand Hip Fracture Registry) Steering Group 2013. Data dictionary. Sydney: ANZHFR. Viewed 5 May 2016, http://www.anzhfr.org/images/resources/Data%20
Dictionary%20v8%20Dec%202013.pdf
.

Metcalfe D 2008. The pathophysiology of osteoporotic hip fracture. McGill Journal of Medicine: MJM 11(1):51-7.

MJA (Medical Journal of Australia) 2013. Building healthy bones throughout life. MJA Open. Volume 2: Supplement 1, 2013.

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