Operationalising a conceptual framework for a contiguous hospitalisation episode to study associations between surgical timing and death after first hip fracture: a Canadian observational study

Figure 1. Admission-based hip fracture episode of care. Letters ‘A’ to ‘N’ correspond to Canadian Institute for Health Information data elements used to identify each event in the care episode. These data elements are described in table 1. Reproduced with permission from The Journal of Orthopaedic Research, John Wiley and Sons.6

Figure 2. Data model to relate multiple abstracts of hip fracture care for a given patient through a series of data tables and establishing relationships between them. Tables include variables relating to patient age (AGE), sex (SEX), admission (ADMISSION_MISCELLANEOUS), discharge (DISCHARGE_MISCELLANEOUS), pre-admission comorbidity (DIAGNOSIS) and hospital (SURGERY_HOSPITAL) and province (SURGERY_PROVINCE) at surgery. Further tables represent abstracts grouped by episodes of care ID (EPISODES), abstracts ungrouped but associated with episodes of care ID (EPISODE_ABSTRACTS) and the admission date and time for each episode of care (ADMISSION_DATE). Dashed arrow from procedures to episode_abstracts represents one-to-one relationship. Dashed arrow from episode_abstracts to episodes and from episodes to sex represents many-to-one relationship. Diamond represents index - the mechanism for more efficient queries. P/key symbol represents primary identifier; unique variable for identification. F/key symbol represents foreign variable from another table to show relationship.

Figure 3. Patient flow n (%) for 189 448 patients after first hip fracture for contiguous hospitalisation episode of care and first abstract episode of care constructs.