The influence of socioeconomic position on patient-reported outcome measures following hip fractures – a register-based observational study on 35,206 patients from the Norwegian hip fracture register 2014–2018
Abstract Background Hip fractures are a significant public health concern due to increasing numbers, high mortality and negative impact on health-related quality of life (HRQoL). Socioeconomic position (SEP) affects various health outcomes, but the specific impact on HRQoL and satisfaction after hip...
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BMC
2025-05-01
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| Series: | Health and Quality of Life Outcomes |
| Online Access: | https://doi.org/10.1186/s12955-025-02377-9 |
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| author | Cato Kjaervik Jan-Erik Gjertsen Eva Stensland Jan Abel Olsen Christer Kjaervik Odd Soereide |
| author_facet | Cato Kjaervik Jan-Erik Gjertsen Eva Stensland Jan Abel Olsen Christer Kjaervik Odd Soereide |
| author_sort | Cato Kjaervik |
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| description | Abstract Background Hip fractures are a significant public health concern due to increasing numbers, high mortality and negative impact on health-related quality of life (HRQoL). Socioeconomic position (SEP) affects various health outcomes, but the specific impact on HRQoL and satisfaction after hip fracture remains underexplored. This study assesses whether education and household income influence patient-reported outcome measures (PROMs) after hip fractures, measured by three visual analog scales: EQ-VAS, pain-VAS, and satisfaction-VAS. Methods This was a nationwide retrospective cohort study using linked data from the Norwegian Hip Fracture Register and Statistics Norway. PROMs assessed at 4, 12, and 36 months postoperatively in 35,206 hip fracture patients from 2015 to 2018 were included. The SEP data included household income and education levels. Covariance analyses were conducted to evaluate differences in mean VAS scores for general health (EQ-VAS), pain from the operated hip (Pain-VAS), and satisfaction with the result of the operation (Satisfaction-VAS). Analyses adjusted for age, sex, vital status, cognitive impairment, treatment type, and education or income when not used as independent variable. Results The study included 23,649 women (67.2%) and 11,557 men (32.8%) with median age 83 years. Lower education was linked to worse EQ-VAS and Pain-VAS scores at all follow-ups and to lower Satisfaction-VAS at 12 and 36 months in both unadjusted and adjusted analyses. Lowest level of income had significant lower EQ-VAS at all follow-ups, lower Pain-VAS at 12 months, and lower Satisfaction-VAS at 4 months. There were increasing differences in mean VAS-scores during follow-up. At 36 months the adjusted differences in mean EQ-VAS between highest and lowest level of income was − 2,51 (-4.04 -0.99). Differences across education levels were even stronger associated; -3.58 (-5.19 to -1.98). Mean differences in Pain-VAS between medium and low education compared to high were 4.30 (2.91 to 5.69) and 5.58 (4.08 to 7.08), respectively. Lower levels of education also had significant negative differences in Satisfaction-VAS at 36 months follow-up -4.06(-5.86 to -2.26). Conclusions Lower education and income were significantly associated with worse HRQoL and satisfaction after hip fracture. The clinical relevance of these findings warrants further investigation. Addressing SEP disparities should be integral to hip-fracture care strategies aiming to improve postoperative outcomes. |
| format | Article |
| id | doaj-art-8081fc49adb84005991dea508a41c8b7 |
| institution | OA Journals |
| issn | 1477-7525 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | Health and Quality of Life Outcomes |
| spelling | doaj-art-8081fc49adb84005991dea508a41c8b72025-08-20T01:49:44ZengBMCHealth and Quality of Life Outcomes1477-75252025-05-0123111110.1186/s12955-025-02377-9The influence of socioeconomic position on patient-reported outcome measures following hip fractures – a register-based observational study on 35,206 patients from the Norwegian hip fracture register 2014–2018Cato Kjaervik0Jan-Erik Gjertsen1Eva Stensland2Jan Abel Olsen3Christer Kjaervik4Odd Soereide5Department of Surgery, Nordland Hospital Trust, Vesteraalen HospitalDepartment of Orthopaedic Surgery, Norwegian Hip Fracture Register, Haukeland University HospitalDepartment of Community Medicine, UiT, The Arctic University of NorwayDepartment of Community Medicine, UiT, The Arctic University of NorwayDepartment of Surgery, Nordland Hospital Trust, Vesteraalen HospitalCentre for Clinical Documentation and Evaluation (SKDE), Northern Norway Regional Health AuthorityAbstract Background Hip fractures are a significant public health concern due to increasing numbers, high mortality and negative impact on health-related quality of life (HRQoL). Socioeconomic position (SEP) affects various health outcomes, but the specific impact on HRQoL and satisfaction after hip fracture remains underexplored. This study assesses whether education and household income influence patient-reported outcome measures (PROMs) after hip fractures, measured by three visual analog scales: EQ-VAS, pain-VAS, and satisfaction-VAS. Methods This was a nationwide retrospective cohort study using linked data from the Norwegian Hip Fracture Register and Statistics Norway. PROMs assessed at 4, 12, and 36 months postoperatively in 35,206 hip fracture patients from 2015 to 2018 were included. The SEP data included household income and education levels. Covariance analyses were conducted to evaluate differences in mean VAS scores for general health (EQ-VAS), pain from the operated hip (Pain-VAS), and satisfaction with the result of the operation (Satisfaction-VAS). Analyses adjusted for age, sex, vital status, cognitive impairment, treatment type, and education or income when not used as independent variable. Results The study included 23,649 women (67.2%) and 11,557 men (32.8%) with median age 83 years. Lower education was linked to worse EQ-VAS and Pain-VAS scores at all follow-ups and to lower Satisfaction-VAS at 12 and 36 months in both unadjusted and adjusted analyses. Lowest level of income had significant lower EQ-VAS at all follow-ups, lower Pain-VAS at 12 months, and lower Satisfaction-VAS at 4 months. There were increasing differences in mean VAS-scores during follow-up. At 36 months the adjusted differences in mean EQ-VAS between highest and lowest level of income was − 2,51 (-4.04 -0.99). Differences across education levels were even stronger associated; -3.58 (-5.19 to -1.98). Mean differences in Pain-VAS between medium and low education compared to high were 4.30 (2.91 to 5.69) and 5.58 (4.08 to 7.08), respectively. Lower levels of education also had significant negative differences in Satisfaction-VAS at 36 months follow-up -4.06(-5.86 to -2.26). Conclusions Lower education and income were significantly associated with worse HRQoL and satisfaction after hip fracture. The clinical relevance of these findings warrants further investigation. Addressing SEP disparities should be integral to hip-fracture care strategies aiming to improve postoperative outcomes.https://doi.org/10.1186/s12955-025-02377-9 |
| spellingShingle | Cato Kjaervik Jan-Erik Gjertsen Eva Stensland Jan Abel Olsen Christer Kjaervik Odd Soereide The influence of socioeconomic position on patient-reported outcome measures following hip fractures – a register-based observational study on 35,206 patients from the Norwegian hip fracture register 2014–2018 Health and Quality of Life Outcomes |
| title | The influence of socioeconomic position on patient-reported outcome measures following hip fractures – a register-based observational study on 35,206 patients from the Norwegian hip fracture register 2014–2018 |
| title_full | The influence of socioeconomic position on patient-reported outcome measures following hip fractures – a register-based observational study on 35,206 patients from the Norwegian hip fracture register 2014–2018 |
| title_fullStr | The influence of socioeconomic position on patient-reported outcome measures following hip fractures – a register-based observational study on 35,206 patients from the Norwegian hip fracture register 2014–2018 |
| title_full_unstemmed | The influence of socioeconomic position on patient-reported outcome measures following hip fractures – a register-based observational study on 35,206 patients from the Norwegian hip fracture register 2014–2018 |
| title_short | The influence of socioeconomic position on patient-reported outcome measures following hip fractures – a register-based observational study on 35,206 patients from the Norwegian hip fracture register 2014–2018 |
| title_sort | influence of socioeconomic position on patient reported outcome measures following hip fractures a register based observational study on 35 206 patients from the norwegian hip fracture register 2014 2018 |
| url | https://doi.org/10.1186/s12955-025-02377-9 |
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