Doctor of Philosophy – Health Sciences (DR-HTHSCI)
Research Proposal
Background
Fractured neck of femur (NOF) among the elderly is a major cause of morbidity and mortality in orthopaedic surgery and levies a huge medico-economic burden on the health system and individuals (Cuesta-Peredó et al., 2018). Numerous studies have been conducted for this population but the current evidence base regarding its financial implications is still weak because of diversity in examining outcomes and management (Tedesco et al., 2018). The number of Australians with fractured NOF has been high in the past and is expected to rise further in the next few years, thus potentially increasing the associated costs (Yoo et al., 2018). Previously, the problem was addressed through surgical repair as a way of restoring normal body functioning, but the outcomes varied among individuals due to the impacts of old age and the expenses incurred (Joosse et al., 2019). Therefore, in quantifying the magnitude of this problem, the research will explore what happened to older people after surgical repair of a broken hip and the associated costs.
Aims
This project aims to:
• Explore what happened to older people after undergoing surgery to repair a broken hip
• Evaluate the associated costs involved when repairing a broken hip
• Research on the mortality rate of older patients following surgery
Methodology
These aims will be achieved by structuring the research as a secondary study that examines the healthcare outcomes of older people and their electronic health records to identify specific patterns and analyse the associated costs of the procedure. An institutional ethics approval will be obtained, after which an examination of electronic patient records will be done to acquire information on what happened to older people following surgical repair of a broken hip and the relevant costs. The collected data will then be de-identified and entered onto an electronic case report form for further evaluation. There is no special equipment or resources needed. To access data, I will follow the protocol of ethical approval and consent from the hospital to obtain patient health records. The primary barrier to collecting data is based on the notion that the study will breach patient privacy. However, to mitigate this, it will be imperative to break through the barriers through consent from the healthcare institution. No travel or fieldwork is required but the project involves human ethics since the data used for the study will be obtained from patient medical records that should be private and only accessible through informed consent.
Expected Outcomes and Significance
The study is important because it will assist in providing data on what happened to older people after surgical repair of a broken hip and the costs incurred. The findings will deliver a diverse framework for quantifying the problem and understanding why the problem has high-cost implications on the healthcare system and to individuals, especially the older people who are the most affected. This project is highly crucial because its originality is based on the fact that today, it is evident that the older people are affected by NOF, and there are cost implications, but evidence remains insufficient on what happened to the old people after surgery to repair the broken bone and the costs incurred after the surgical process. The innovative applications of knowledge ascertain that understanding the outcomes of surgery among the older people to repair the broken bone and the costs involved would be similarly applied to current interventions if the outcomes were positive to increase the use of surgery or refrain from the intervention if the outcomes were unsuccessful (Joosse et al., 2019).
Timeline
Following ethics approval, the total timeframe for the PhD project will be three years from: December 2020 to December 2022. The bulky portion would be conducting literature surveys, data collection, producing statistical models and modelling review. These would take around 15 months. The remaining time will be utilized for analysis, testing, reporting chapter and thesis writing, plus, submission and presentation of findings.
References
Cuesta-Peredó, D., Segarra-Muñoz, B., DE la Camara, J. M., Sanchez-Cortes, A., Arteaga-Moreno, F., & Tarazona-Santabalbina, F. J. (2018) Factors associated with cost variations in patients with hip fracture: Mini-review. Am J Gerentol Geriatr. 2018; 1 (1), 1005.
Joosse, P., Loggers, S. A., Van de Ree, C. M., Van Balen, R., Steens, J., Zuurmond, R. G., … & Van Lieshout, E. M. (2019). The value of nonoperative versus operative treatment of frail institutionalized elderly patients with a proximal femoral fracture in the shade of life (FRAIL-HIP); protocol for a multicenter observational cohort study. BMC Geriatrics, 19(1), 1-12.
Tedesco, D., Gibertoni, D., Rucci, P., Hernandez-Boussard, T., Rosa, S., Bianciardi, L., … & Fantini, M. P. (2018). Impact of rehabilitation on mortality and readmissions after surgery for hip fracture. BMC Health Services Research, 18(1), 701.
Yoo, J. I., Lee, Y. K., Koo, K. H., Park, Y. J., & Ha, Y. C. (2018). Concerns for older adult patients with acute hip fracture. Yonsei Medical Journal, 59(10), 1240-1244.