[Evaluation of the tracer diagnosis "femoral neck fracture". A report of 5 years external quality assurance].
A report card system for fractures of the femur neck has been established at the department of external quality assurance of the chamber of physicians of Westphalia-Lippe since 1993. Since then several indicators of good quality have significantly changed: conservative treatment decreased from 6.8% 1993 to 4.2% in 1997, lethality decreased from 6.9% to 5.4%, average length of stay before operation decreased from 2.6 to 2.1 days, the frequency of operations on weekends increased, complications in wound healing increased from 4.9 to 6.0%, cardiopulmonary complications decreased from 11.2% to 7.8%. Between 1993 to 1997 54.3% could be dismissed to their homes; the percentage of patients being sent to rehabilitation facilities after acute care rose from 8.3% in 1993 to 20.1% in 1997. Operative treatment was performed in more than 90% of all fractures in all counties of Westphalia-Lippe. However, there was a wide and significant geographical variation in the choice between osteosyntheses and hip replacement: the percentage of hip replacement differed between 57% and 82% among different counties.
Smektala
R
R
Abteilung für Unfallchirurgie, Knappschaftskrankenhaus Bochum Langendreer, Ruhr Universität Bochum.
Wenning
M
M
Luka
M
M
Ekkernkamp
A
A
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D005265:Femoral Neck Fractures / Q000401:mortality / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000706:statistics & numerical data; D005858:Germany; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011785:Quality Assurance, Health Care; D015996:Survival Rate; D014600:Utilization Review