The effectiveness of a multidisciplinary hip fracture care model in improving the clinical outcome and the average cost of manpower

Lau, Tak-Wing; Fang, CX; Leung, Fkl

doi:10.1007/s00198-016-3845-7

Cited by 23 publications

(31 citation statements)

References 26 publications

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“…At present, many studies have investigated and proved the benefits of multidisciplinary orthogeriatric care for elderly hip-fracture patients [ 11 – 13 ]. Only few studies however, have analyzed treatment concepts for those patients directly following the discharge from hospital in specialized rehabilitation centers [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary inpatient rehabilitation improves the long-term functional status of geriatric hip-fracture patients

et al. 2020

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Background: As the world population ages, the number of hip-related fractures in the elderly is steadily increasing. These fractures generate a major worldwide healthcare problem and frequently lead to deterioration of life quality, mobility and independence in activity of daily life of geriatric patients. At present, many studies have investigated and proved benefits of multidisciplinary orthogeriatric care for elderly hip-fracture patients. Only few studies however, have analyzed treatment concepts for those patients directly following discharge from hospital in specialized rehabilitation centers. The aim of this study was to evaluate effects of a multidisciplinary inpatient rehabilitation on the shortand long-term functional status of geriatric patients who suffered from hip fracture. Methods: A total of 161 hip-fracture patients aged 80 years and above, or additionally 70 years and above suffering from age-typical multimorbidity were included in this study. Patients who had an initial Barthel Index lower than 30 points were excluded from this study, as most of these patients were not able to attend a therapy at the rehabilitation center due to a poor functional status. The patients were separated into two subgroups dependent on the availability of treatment spots at the rehabilitation center. No other item was used to discriminate between the groups. Group A (n = 95) stayed an average of 21 days at an inpatient rehabilitation center that specialized in geriatric patients. Group B (n = 66) underwent the standard postoperative treatment and were sent home with further treatment by their general practitioner, nursing staff and physiotherapists. To evaluate the patients' functional status over the course of time we used the Barthel Index, which was evaluated for every patient on the day of discharge, as well as during checkups after 3, 6 and 12 months. Results: The average Barthel Index at the day of discharge was 57.79 ± 14.92 points for Group A and 56.82 ± 18.76 points for Group B (p = 0.431). After 3 months, the average Barthel Index was 82.43 points for Group A and 73.11 points for group B (p = 0.005). In the 6-month checkup Group A's average Barthel Index was 83.95 points and Group B's was 74.02 points (p = 0.002). After 12 months, patients from Group A had an average Barthel Index of 81.21 while patients from Group B had an average Barthel Index of 69.85 (p = 0.005). Conclusion: The results of this study reveal a significantly better outcome concerning both, short-term and longterm functional status after 3, 6 and 12 months for geriatric hip-fracture patients, who underwent an inpatient treatment in a rehabilitation center following the initial therapy.

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Section: Introductionmentioning

confidence: 99%

Multidisciplinary inpatient rehabilitation improves the long-term functional status of geriatric hip-fracture patients

et al. 2020

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“…Resultados semelhantes foram encontrados por Ginsberg et al (2013), Lau et al (2017) e Leal et al (2017) na avaliação do custo-efetividade da introdução de cuidados multidisciplinares no tratamento de idosos com fratura de quadril.…”

Section: Discussionunclassified

Análise do custo-efetividade da implantação de uma Unidade de Prática Integrada no cuidado de idosos com fratura do quadril

Avelino¹,

Chaoubah²,

Fernandes³

et al. 2020

JBES

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“…However, even without the inducement of BPT payments outside of the UK, integrated services have been found to be more cost-effective in moderate volume units and are cost-saving in high-volume units [46]. The majority of these effects appear to be due to a reduction in length of hospital stay [47,48,49], but expediting the time to surgical treatment also contributes [50].…”

Section: Clinical Governance Incentives and Financesmentioning

confidence: 99%

Orthogeriatrics and Hip Fracture Care in the UK: Factors Driving Change to More Integrated Models of Care

Middleton

2018

Geriatrics

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In the United Kingdom (UK), approximately 80,000 hip fractures each year result in an estimated annual cost of two billion pounds in direct healthcare costs alone. Various models of care exist for collaboration between orthopaedic surgeons and geriatricians in response to the complex medical, rehabilitation, and social needs of this patient group. Mounting evidence suggests that more integrated models of orthogeriatric care result in superior quality of care indicators and clinical outcomes. Clinical governance through national guidelines, audit through the National Hip Fracture Database (NHFD), and financial incentives through the Best Practice Tariff (providing a £1335 bonus for each patient) have driven hip fracture care in the UK forward. The demanded improvement in quality indicators has increased the popularity of collaborative care models and particularly integrated orthogeriatric services. A significant fall in 30-day mortality has resulted nationally. Ongoing data collection by the NHFD will lead to greater understanding of the impact of all elements of hip fracture care including models of orthogeriatrics.

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The effectiveness of a multidisciplinary hip fracture care model in improving the clinical outcome and the average cost of manpower

Abstract: This study proves that the GHFCP shortened the geriatric hip fracture patients' length of stay and improves the clinical outcomes. It is also cost-effective which proves better care is less costly.

Cited by 23 publications

References 26 publications

Multidisciplinary inpatient rehabilitation improves the long-term functional status of geriatric hip-fracture patients

Multidisciplinary inpatient rehabilitation improves the long-term functional status of geriatric hip-fracture patients

Análise do custo-efetividade da implantação de uma Unidade de Prática Integrada no cuidado de idosos com fratura do quadril

Orthogeriatrics and Hip Fracture Care in the UK: Factors Driving Change to More Integrated Models of Care

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