Research Project - KlinReg
Hip fractures in Norway – Inequality in treatment and outcomes
There are nearly 9,000 hip fractures per year in Norway, equivalent to one fracture every hour. The number of hip fractures will increase significantly towards the year 2050, even if it is possible to reduce the incidence through good preventive treatment due to demographic changes.
About the Project
The nearly 9,000 patients who suffer from hip fractures each year are affected in terms of their quality of life and functional level. We know that there is geographical inequality in the treatment patients receive. By increasing adequate fracture prevention osteoporosis treatment, we can significantly reduce the burden on patients and society. A reduction of up to 40% in hip fractures can be achieved with adequate prophylaxis. The project will also help clarify treatment options for a significant subgroup of hip fracture patients. Since over 40% of patients require municipal health and care services in the course following a hip fracture, better treatment outcomes for patients could reduce the burden on municipalities.
With an increasing number of elderly people in the future, a rising number of hip fractures, and fewer available staff in the healthcare service (Government's perspective report 2024), it is important to optimize services for patients to maintain a sustainable health and care service in the future. Better data sources with more differentiated quality of life measures and person-specific data from the municipal health service can help address this. The project will respond to the Ministry of Health and Care Services' call for research-based mapping of variation so that decision-makers and professional environments can "deliver" equitable services.
Purpose of the Project
The aim of the research project was to illuminate variation in treatment and outcomes after hip fractures in Norway, map explanations for and consequences of variation, assess risk factors for death after hip fractures and their relative significance. Additionally, the intention was to evaluate the survival pattern and estimate the duration of excess mortality after hip fractures.
To generate knowledge that can explain geographical variation in specialist healthcare and provide a knowledge base to reduce this.
We use the following data sources: Norwegian Patient Registry, Municipal Patient and User Registry, medical quality registers (National Hip Fracture Registry), Cause of Death Registry, and Statistics Norway.
Research Questions
- Is there geographical and unjustified variation in the treatment of hip fractures in Norway in light of national and international guidelines?
- Is there geographical variation in survival after hip fractures?
- What patient and contextual factors influence survival function?
- Paper I: Kjaervik, C., Stensland, E., Byhring, H.S., Gjertsen, J.-E., Dybvik, E. & Soereide, O. (2020). Hip fracture treatment in Norway deviation from evidence-based treatment guidelines: data from the Norwegian Hip Fracture Register, 2014 to 2018. Bone & Joint Open, 1(10), 644-653
- Paper II: Kjaervik, C., Gjertsen, J.-E., Engeseter, L., Stensland, E., Dybvik, E. & Soereide, O. (2021). Waiting time for hip fracture surgery: hospital variation, causes, and effects on postoperative mortality: data on 37,708 reported operations to the Norwegian Hip Fracture Register from 2014 to 2018. Bone & Joint Open, 2(9), 710-720.
- Paper III: Kjaervik, C., Gjertsen, J.-E., Stensland, E., Saltyte-Benth, J. & Soereide, O. (2022). Modifiable and non-modifiable risk factors in hip fracture mortality in Norway, 2014 to 2018 - a linked multiregistry study. The Bone & Joint Journal, 104-B(7), 884-893.
- Hip fractures in Norway – Inequity in treatment and outcomes
- Patient-reported outcome measures in hip fracture patients
Project participants
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Cato Kjærvik
Project Manager
Ph.D. candidate
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Barthold Vonen
Main supervisor
Professor, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway.
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Eva Stensland
Co-advisor
Associate Professor, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway.
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Odd Søreide
Co-advisor
Professor emeritus