Table III.
Difference-in-difference (DID) results before and after Best Practice Tariff (BPT) implementation among adults aged more than 60 years, 2000 to 2016. DID compared differences in mortality trends before (January 2000 to December 2006) and after (April 2010 to December 2016) combined policy implementation in 2007 to 2010 in England versus Scotland, ‘intervention overall’. They also broke down contributions to differences in mortality before (January 2000 to December 2016) and after (January 2008 to March 2010) introduction of the National Hip Fracture Database (NHFD) and clinical audit alone in 2007, ‘NHFD introduced’; and before (January 2008 to March 2010) and after (April 2010 to December 2016) formal introduction of payment penalties under the Best Practice Tariff alone in 2010, ‘BPT introduced’
| Scotland | England | NHFD introduced | BPT introduced | Intervention overall | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2000 to 2006 | 2007 to 2009 | 2010 to 2016 | 2000 to 2006 | 2007 to 2009 | 2010 to 2016 | DID | 95% CI | p-value | DID | 95% CI | p-value | DID | 95% CI | p-value | |
| Mortality, % | |||||||||||||||
| 30-day | 9.8 | 8.8 | 8.5 | 9.8 | 8.7 | 6.8 | -0.1 | 0.5 to 0.5 | 0.987 | 1.6 | 2.1 to 1.2 | < 0.001 | 1.7 | 2.0 to 1.2 | < 0.001 |
| 60-day | 15.4 | 13.8 | 13.1 | 15.6 | 14.0 | 11.4 | 0.0 | 0.6 to 0.6 | 0.994 | 1.9 | 2.5 to 1.3 | < 0.001 | 1.9 | 2.3 to 1.4 | < 0.001 |
| 90-day | 18.9 | 17.3 | 16.4 | 19.4 | 17.6 | 14.7 | -0.2 | 0.9 to 0.5 | 0.581 | 2.0 | 2.6 to 1.3 | < 0.001 | 2.2 | 2.6 to 1.6 | < 0.001 |
| 365-day | 32.0 | 30.4 | 29.8 | 31.9 | 30.2 | 27.8 | -0.1 | 1.0 to 0.6 | 0.688 | 1.8 | 2.5 to 1.0 | < 0.001 | 1.9 | 2.5 to 1.3 | < 0.001 |
| Re-admission, % | |||||||||||||||
| 30-day | 11.1 | 11.9 | 12.2 | 20.5 | 20.0 | 21.0 | -1.3 | 1.9 to 0.6 | < 0.001 | 0.7 | 0.1 to 1.4 | 0.051 | 0.6% | 1.1 to 0.1 | 0.038 |
| Length of stay | |||||||||||||||
| 50th percentile | 20.0 | 21.0 | 20.0 | 17.0 | 14.0 | 12.0 | -4.0 | -4.4 to -3.6 | < 0.001 | -1.0 | -1.4 to -0.6 | < 0.001 | -5.0 | -5.3 to -4.7 | < 0.001 |
| 60th percentile | 28.0 | 29.0 | 26.0 | 21.0 | 18.0 | 15.0 | -4.0 | -4.4 to -3.6 | < 0.001 | 0.0 | -0.1 to 0.1 | 0.999 | -4.0 | -4.2 to -3.8 | < 0.001 |
| 70th percentile | 38.0 | 39.0 | 36.0 | 28.0 | 22.0 | 19.0 | -7.0 | -7.5 to -6.5 | < 0.001 | 0.0 | -0.2 to 0.2 | 0.999 | -7.0 | -7.2 to -6.8 | < 0.001 |
| 80th percentile | 53.0 | 54.0 | 50.0 | 37.0 | 30.0 | 25.0 | -8.0 | -9.1 to -6.9 | < 0.001 | -1.0 | -1.7 to -0.3 | 0.008 | -9.0 | -9.7 to -8.3 | < 0.001 |
CI, confidence interval