title: Time to surgery for hip fracture patients in a rural orthopaedic referral hospital.
abstract: OBJECTIVE
  It is well established that shorter surgical waiting time for hip fracture patients improves outcomes. We identify and quantify time to surgery for hip fracture patients in a rural hospital.
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  : A sixty-bed rural referral hospital with an orthopaedic service. Data were collected for 57 patients 50 years and older who had surgery for Muller AO type 31-A and 31-B fractures at Bega Hospital in 2012.
  
  
  METHODS
  Time to surgery from presentation was compared for patients who presented directly to Bega hospital to those that were transferred from a peripheral hospital.
  
  
  METHODS
  To quantify contributing factors to surgical delay will help identify areas for future improvement.
  
  
  RESULTS
  Delay to surgery from presentation was significantly greater for transferred patients (58 hours), compared with direct presentations (41 hours). Mean time for patient transfer was 23 hours. Thirty-five per cent of patients had their operation within 36 hours from presentation.
  
  
  CONCLUSIONS
  The time to surgery for most transfer and direct presentation patients fell outside current guidelines. In our geographically large referral network, delay to surgery was significantly influenced by time to transfer. Based on previously published research, surgery for our hip fracture patients should be expedited. We therefore recommend priority transfer for these significantly injured patients and dedicated emergency operating lists to perform this surgery in a timely manner.
authors: Orthopaedic Department, Bega District Hospital, Bega, New South Wales, Australia.
authors: Yoshio Robert
authors: YR
authors: Hinde
authors: Orthopaedic Department, Bega District Hospital, Bega, New South Wales, Australia.
authors: Richard
authors: R
authors: Pennington
authors: Orthopaedic Department, Bega District Hospital, Bega, New South Wales, Australia.
authors: Matthew Lewis
authors: ML
authors: Nott
mesh_terms: D005592:Fracture Fixation / Q000706:statistics & numerical data*; D006620:Hip Fractures / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D009517:New South Wales; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000458:organization & administration*; D013997:Time Factors
keywords: elderly; health services access; health system; proximal femur; trauma