Hip fracture patients occupy 80,000 acute bed days in 2025

Less than four-in-ten patients were left in an ED for more than four hours last year, while 79 per cent received surgery within 48 hours of admission

Almost 80,000 acute hospital bed days in Ireland last year were occupied by patients with a hip fracture, a national audit has found.

The 2025 report from the Irish Hip Fracture Database (IHFD) reviewed more than 4,000 patients across 16 trauma-receiving hospitals. It noted that median length of stay for hip fracture patients in 2025 was 12 days, while 79 per cent received surgery within 48 hours of admission.

However, fewer than four-in-ten (39 per cent) were admitted to an orthopaedic ward or went to the operating theatre within four hours of arrival to an operating hospital. Lack of available ward beds, and delays in receiving an orthopaedic diagnosis were cited for longer-than-recommended ED stays.

While 90 per cent received a specialist falls assessment, just 61 per cent had a recorded delirium assessment on day one of their hospital admission.

Almost one-in-four patients received ‘best practice’ care as defined by Irish Hip Fracture Standards. As a result, more than €1 million was paid out to hospitals under the Hip Fracture Tariff programme, which financially incentivises high-quality care.

In the report’s foreword, consultant physician in geriatric medicine Prof Emer Ahern said: “Hip fracture remains one of the most significant health events affecting older adults.

“In 2025, all seven Irish Hip Fracture Standards improved compared with the previous year, while achievement of the Best Practice Tariff reached its highest level since introduction.

“This demonstrates the dedication of clinicians, managers, audit coordinators and multidisciplinary teams working together across Ireland to improve care at every stage of the patient pathway.”

In total, 79,993 acute hospital bed days were occupied by 4,356 patients with a hip fracture last year. Upon leaving hospital, 22 per cent were discharged directly home, while 45 per cent were transferred to an on-site or off-site rehabilitation unit or to early-supported discharge. Thirteen per cent were discharged to convalescence care or a model two or three hospital.

Just over half of patients received a Cumulated Ambulation Score (CAS) – a measure of mobility – after surgery or at discharge. Of those, 27 per cent had achieved independent mobility on the day they were discharged.

Sixty-seven patients – two per cent – underwent re-operation within 30 days. Less than one per cent had a surgical site infection, while four per cent died as inpatients.

Of the 16 hospitals included in the audit, ten actively recorded follow-on outcomes including mobility and mortality.

This year the IHFD completed a comprehensive review of orthogeriatric standards. The resulting revised standards, to be introduced from January 2027, aim to better reflect contemporary evidence and practice through an increased focus on comprehensive geriatric assessment, delirium care and secondary fracture prevention.