Sample and setting
fracture, fractures, terminally ill
PATHOLOGICAL FRACTURE
Hip fracture patients ≥ 18 years of age who were admitted to a Norwegian public regional hospital and followed an in-hospital standardised fast track procedure for hip fracture management could be included in the study. Patients were included irrespective of residence, with both high- and low-energy fractures. The in-hospital fast track was a procedure describing patient flow and healthcare professionals’ responsibility through all hospital settings. Exclusion criteria were terminally ill patients (life expectancy less than one week) and non-fast track patients (e.g. pathological fracture and fracture in already hospitalised patients). After discharge, a majority of patients received initial rehabilitation care in an institution prior to returning to their habitual accommodation with or without district (home care) nursing services, or a prolonged nursing home stay. The great majority of the Norwegian healthcare system is public with universal access.The intervention group were patients admitted from 03 September 2018 to 04 April 2019. The patient last admitted was assessed for eligibility without any details except name, date of birth, and time of admission to avoid selection bias. The control group constituted a retrospective sample of hip fracture patients randomly selected using a random number generator (Mersenne Twister, Microsoft Excel 2016). Patients discharged from the hospital within the three pre-intervention months (01 June–31 August 2018) were eligible as controls. As control patients were included retrospectively and the primary outcome was discharge summary score (described below), patients who died during hospitalisation were excluded from this group.