What is the study about?
The ARTHUR (Avoidable Readmission After Hip Fracture) study aims to understand why some people need to return to hospital soon after treatment for a broken hip. Returning to hospital after leaving is called a readmission. Some readmissions are necessary. Others may be prevented with the right care and support. The study will look at which readmissions could be prevented and how care could be improved.
The research will:
- Explore what makes a readmission after a broken hip avoidable.
- Find out why people return to hospital within 30 days of leaving.
- Look at whether age, social and financial disadvantage, and time spent in hospital are linked to readmission.
- Suggest changes to care and support that could help prevent unnecessary readmissions.
Why is this research needed?
Around 75,000 people are admitted to hospital with a broken hip each year in the United Kingdom. Most are older people, and the injury often follows a fall. A broken hip can have a major effect on a person’s ability to move around, live independently and enjoy life.
More people now survive a broken hip than a decade ago. However, readmissions within 30 days of leaving hospital have become more common. People may return because of wound problems, difficulty moving around, other health conditions, problems with medicines, or difficulties during recovery.
Returning to hospital is sometimes the right and necessary step. But research suggests that some readmissions could be prevented. Better planning before people leave hospital, clearer communication between care services, and support during recovery may help.
People who return to hospital after a broken hip often have a more difficult recovery. Readmissions also put pressure on NHS services. Understanding why they happen could help improve care.
What will the researchers do?
The researchers will use information collected as part of usual healthcare. They will look at records from people treated for a broken hip in the past and people newly admitted to hospital. This will help them understand what happens after people leave hospital.
The team will:
- Look at how often people returned to hospital over the previous five years, and continue to monitor readmissions during the study.
- Look for patterns linked to age, sex, social and financial disadvantage, and time spent in hospital.
- Find the most common reasons why people return to hospital after a broken hip.
- Explore how care services, plans for leaving hospital, and support to regain strength and independence may affect readmissions.
- Ask patients, carers and healthcare professionals which readmissions they think could be prevented and why.
The team will use the findings to develop possible changes to care. These could be tested in future studies to see whether they help people recover and reduce unnecessary returns to hospital.
How are patients and the public involved?
Patients and members of the public have helped shape the study from an early stage. Feedback from patient groups, including the Clinical Research Ambassadors Group and the Muscle Health Group, has helped the team plan the research and develop information for patients.
The project has funding for a group of six patients and members of the public to meet regularly throughout the study. They will help guide the research, discuss the findings and keep the work focused on what matters most to patients and carers.
Who supports and leads the study?
All members of the PIONEER Data Trust Committee supported the project.
The study is led by Dr Emma Sutton at University Hospitals Birmingham NHS Foundation Trust. She is the Clinical Academic Lead for Nursing, Midwifery, Allied Health Professionals and Healthcare Scientists. She is working with researchers from the University of Birmingham and University Hospitals Birmingham.
