Grant: Travel Awards - Institute Community Support

When old people fall they sometimes break their hip. They then go to hospital to get better. They might go to a hospital where new doctors and nurses are taught to care for people. The hospital they go to may also be small or big. In Canada we do not know if people who have their hip fixed at teaching hospitals die less than people who have their hip fixed at non-teaching hospitals. We also do not know if more people die at small or big hospitals. This study helps to answer these questions. We looked at 167,816 hospital files of people older than 65 years of age, who went to hospital with a broken hip between 2004 and 2012 in Canada. We were interested to see how many people died in hospital before having an operation to fix their hip, and how many people died in hospital after an operation to fix their hip. We looked to see whether the number of people who died was different for teaching and large (more than 199 beds), medium (50-199 beds) or small (less than 49 beds) non-teaching hospitals. A similar number of people died before an operation or after an operation at teaching and large non-teaching hospitals. More people died before an operation or after an operation at medium non-teaching hospitals compared to teaching hospitals. More people died before an operation at small non-teaching hospitals compared to teaching hospitals. Very few people had their operation at small non-teaching hospitals. Our results suggest the type of hospital people go to after they break their hip can affect whether they die or not. In particular, more people died at medium and small non-teaching hospitals before an operation. This might be because these hospitals do not have as many doctors, nurses, equipment or beds to care for these people.