Closeup of man on crutches being helped to walk by a physical therapist

Hip fractures are a common and costly problem in older adults, and a new study finds there is a substantial variation in mortality, health outcomes and treatment measures among different countries.

An international team of researchers performed a retrospective cross-sectional cohort study of older adults (age 66 and above) who were hospitalized with hip fractures between 2011 and 2018 in the U.S., Canada, England, the Netherlands, Taiwan and Israel. The research team examined mortality; different hip fracture treatment approaches; and health system performance measures, including hospital length of stay, 30-day readmission rates and time-to-surgery in the different countries.

The study found substantial variations in the number of hip fracture admissions, mortality, length of hospital study and treatment processes in the six countries. For example, researchers found that total number of fracture admissions between 2011 and 2018 ranged from 23,941 in Israel to more than 1.2 million in the US.

Overall, internal fixation (IF) was the most common surgery performed in all countries, accounting for approximately 60% of patients in the US and Israel, but only 40% in England. The mean hospital length of stay in 2018 ranged from 6.4 days in the U.S. to 18.7 days in England, while the 30-day readmission rate in 2018 ranged from 8% in Canada and the Netherlands to nearly 18% in England.

“We observed substantial between-country variation in mortality, surgical approaches, and health system performance measures,” the authors concluded. “These findings underscore the need for further research to inform evidence-based surgical approaches.

The study was published Aug. 11 in the Journal of the American Geriatrics Society.