[Multidisciplinary integrated care pathway for elderly patients with hip fractures: implementation results from Centre for Geriatric Traumatology, Almelo, The Netherlands].
| Autor: | Folbert E; Ziekenhuisgroep Twente, Almelo, Afd. Chirurgie, the Netherlands. e.folbert@zgt.nl, Smit R, van der Velde D, Regtuijt M, Klaren H, Hegeman JH |
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| Jazyk: | Dutch; Flemish |
| Zdroj: | Nederlands tijdschrift voor geneeskunde [Ned Tijdschr Geneeskd] 2011; Vol. 155 (26), pp. A3197. |
| Abstrakt: | Objective: To evaluate the effects of the implementation of a multidisciplinary treatment approach at Hospital Group Twente in Almelo, Netherlands, of hip fracture patients aged 65 years and older. Design: Historical comparative cohort study. Method: Two groups of patients with hip fractures were retrospectively compared. One of these groups had been treated in 2009 according to the new, multidisciplinary treatment approach; the other in 2007 by usual means. Observations included the duration of hospital stay, as well as the numbers of complications, readmissions and consultations by other specialities. Results: Included were 101 patients from 2009 and 69 from 2007. In 2009, the mean duration of hospital stay was 1 day longer than in 2007. Patients admitted to a nursing home for rehabilitation increased by 16 percentage points. The incidence of minor complications decreased by 7 percentage points; that of severe complications, 5 percentage points. The diagnosis of delirium was made significantly more often (15 percentage points more; p-value: 0.051). The rate of death decreased by 5 percentage points. The number of readmissions within 30 days declined by 14 percentage points (p-value: 0.001). Due to geriatric co-treatment (co-managed care), consultations by various specialities were fewer per patient. Conclusion: No reduction in the duration of hospital stay was achieved by implementation of the multidisciplinary treatment approach. It did appear that a relationship with better short-term treatment outcomes for the elderly with hip fractures existed. |
| Databáze: | MEDLINE |
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