Fall with fractured neck of femur (NOF) admissions

Description
This indicator provides further insight into the relative levels of serious harm and acute hospital admission due to falls resulting in fractured NOFs. A hospital admission indicated that there was a serious injury as a result of a fall. Serious injuries take longer to rehabilitate, which leads to a greater loss of independence and quality of life and increases use of health services.
Notes about this measure set
Type of fall injury is based on the first event in the stay.
Fractured neck of femur: ICD-10 code S720* to S722* in diagnosis codes 1–30


Calculating stays

Consecutive events that together make a stay are calculated with a similar methodology to the Manatū Hauora system-level measure Acute Hospital Bed Days.
Events are considered part of the same stay if:
  • the NHI was the same
  • the previous event had a transfer end type (DA, DF, DO, DP, DT, DW or ET)
  • the end date of the previous event was before or within 1 day of the next event
  • there was an external cause code of a fall (W00–W19) that occurred either on or before the event start date.
All sub-analyses are based on the information recorded in the first event in the stay.

Sub-analysis is available using the following filters:
  • Te Whatu Ora district
  • ethnicity (Māori, Pacific, Asian and Other [including unknown]).
This indicator differs from the falls indicator in the Te Tāhū Hauora Atlas of Healthcare Variation, as it counts all acute/arranged hospital admissions (stays), rather than people with more than one fall only counted once.
Numerator
The number of acute and arranged fractured NOF admissions (stays) in the hospital as the result of a fall.
Denominator
Resident population, Stats NZ population projections.
Denominator detail
Stays included in this measure are those that:
  • started with an acute or arranged event (admission type codes AA, AC, ZA or ZC)
  • started with an event with an external cause code of a fall (W00–W19) that occurred either on or before the event start date.
  • started with an event with a diagnosis code of fractured NOF (ICD-10 code S720* to S722*).
ED short stays (treatment in ED for 3 hours or more) are also included.
Denominator exclusions
Stays excluded from this measure are those that:
  • had an unknown health district, age or gender
  • consisted of only non-case-mix events (EXCLU purchase unit); non-case-mix events are otherwise included as long as a case-mix event is within the stay
  • start with a non-acute event code (ie, excluding falls that clearly occur in hospitals, like those measured in the Te Tāhū Hauora quality and safety markers).