Association of two geriatric treatment systems on care home admission and mortality in patients with hip fracture

Abstract

Background In Germany, geriatricians deliver acute geriatric care during an acute hospital stay and subacute rehabilitation after transfer to a rehabilitation clinic. However, the proportion of patients who receive acute geriatric care (AGC) or are transferred to subacute rehabilitation (TSR) differs considerably between hospitals. The aim of this study was to analyse the association between the two geriatric treatment systems and care home admission or mortality in patients following hip fracture. Methods Health insurance claims data were used to identify the rate of AGC per hospital and the rate of TSR per hospital following hip fracture surgery in patients aged ≥ 80 years. Outcomes were cumulative admission to a care home and cumulative mortality within 6 months after hospital admission. Results Data from 23,046 hip fracture patients from 561 hospitals were analysed. The rate of AGC was not associated with care home admission. However, compared to high rates of AGC medium rates or no AGC were associated with increased death rates by 12% or 20%, respectively. Treatment in hospitals with low rates of TSR was associated with a 8% higher risk of care home admission and a 10% increased risk of death compared to treatment in hospitals with high rates of TSR. Conclusions Our study suggests potential effects of geriatric treatment: reduction of mortality in hospitals with high rates of AGC or reduction of care home admission and mortality in hospitals with high rates of TSR.

Effect of individualized narrative nursing mode on recovery of elderly patients with fracture complicated with cerebrovascular accident

“…We also create narrative materials based on the patient’s mood and needs, and feedback on treatment interventions and outcome evaluations to discover the highlights of the patient’s illness experience. [29,30] Provide treatment documentation based on the patient’s needs, thereby strengthening the patient’s positive self-perception, weakening the patient’s negative self-perception, and reinventing themselves. [31] These bright spots are good things for patients, and helping patients to recall these beautiful things can not only relax the mood of patients.…”

Effect of individualized narrative nursing mode on mental health, cognitive function and limb function recovery of elderly patients with fracture complicated with cerebrovascular accident

“…Narrative nursing is to collect the basic materials of the patients to externalize, deconstruct and rewrite the patients' conversations and evaluate the narrative stories through the conversation with the patients. We also create narrative materials based on the patient's mood and needs, and feedback on treatment interventions and outcome evaluations to discover the highlights of the patient's illness experience [29][30]. Provide treatment documentation based on the patient's needs, thereby strengthening the patient's positive self-perception, weakening the patient's negative selfperception, and reinventing themselves [31].…”