National Institute for Health Research
I am carrying out research to evaluate improvements to hospital services for older people with a hip fracture, funded by an NIHR postdoctoral fellowship. Using large datasets from the Hospital Episode Statistics (HES) and the National Hip Fracture Database (NHFD), the aim is to find out which national policy changes, and which local changes to hospital services, have been effective in improving patient care and reducing mortality over the last decade.
The complex multilevel structure of the data allows several options for analysis. In this fellowship, I propose to adapt statistical techniques used for analysing complex data structures in other contexts. For example, techniques of multivariate meta-analysis (MV-meta) may be used to estimate and combine parameters that describe effects of organisational changes on mortality at the hospital level.
The HES database contains records of more than half a million hospital admissions for hip fracture over the last decade. This has been linked to ONS mortality data, which permits the analysis of deaths inside and outside hospital. It will also be linked to the NHFD, which contains more than 250,000 records with details of patients’ clinical care going back to 2007, and to hospital-level data on staffing and organisation of services.