11-year results in 2,846 patients of the Peterborough Hip Fracture Project: Reduced morbidity, mortality and hospital stay

3,025 consecutive patients presenting over an 11-year period with an acute hip fracture were prospectively studied to determine the effectiveness of a designated hip fracture service. After the introduction of the service, the mean length of hospital stay per patient was reduced from 51 days to 21 days. This reduction was accomplished by a progressive increase in the proportion of patients discharged directly home from the admission ward (50%-86%) and a reduction in the numbers of patients transferred to care of the elderly wards (28%-6%) and other outlying wards (15%-3%). This change was accompanied by a reduction in the 30-day mortality rate from 22% to 7%. There was no significant increase in the re-admission rate or proportion of patients requiring institutional care. We conclude that the provision of designated staff and treatment regimes for hip fracture patients can result in a significant reduction in both mortality and morbidity, combined with substantial savings in patient bed-days.