Effects of hospitalist co-management on rate of initiation of osteoporosis treatment in patients with vertebral compression fractures: Retrospective cohort study.

Autor:	Tsunemitsu A; Department of General Internal Medicine, Takatsuki General Hospital, 1-3-13 Kosobe-Cho, Takatsuki, Osaka 569-1192, Japan; Department of Healthcare Economics and Quality Management, Graduate School of Medicine and Faculty of Medicine, Kyoto University, Yoshida Konoe-Cho, Sakyo-Ku, Kyoto 606-8501, Japan. Electronic address: miki.ayako@aijinkai-group.com., Tsutsumi T; Department of General Internal Medicine, Takatsuki General Hospital, 1-3-13 Kosobe-Cho, Takatsuki, Osaka 569-1192, Japan; Department of Healthcare Economics and Quality Management, Graduate School of Medicine and Faculty of Medicine, Kyoto University, Yoshida Konoe-Cho, Sakyo-Ku, Kyoto 606-8501, Japan., Inokuma S; Department of General Internal Medicine, Takatsuki General Hospital, 1-3-13 Kosobe-Cho, Takatsuki, Osaka 569-1192, Japan., Kobayashi T; Department of General Internal Medicine, Takatsuki General Hospital, 1-3-13 Kosobe-Cho, Takatsuki, Osaka 569-1192, Japan., Imanaka Y; Department of Healthcare Economics and Quality Management, Graduate School of Medicine and Faculty of Medicine, Kyoto University, Yoshida Konoe-Cho, Sakyo-Ku, Kyoto 606-8501, Japan.
Jazyk:	angličtina
Zdroj:	Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association [J Orthop Sci] 2023 Nov; Vol. 28 (6), pp. 1359-1364. Date of Electronic Publication: 2022 Oct 13.
DOI:	10.1016/j.jos.2022.09.013
Abstrakt:	Background: Vertebral compression fractures are common in elderly people and most are due to osteoporosis. Osteoporosis treatment is effective for secondary prophylaxis, so initiation is recommended. Despite the clear benefits, the rate of initiation of osteoporosis treatment is very low. It is reported to be due to several factors including insufficient systems-based approaches for hospitals and post-acute care. Hospitalists, who are physicians dedicated to the treatment of patients in hospital and whose activity is generalist rather than specialized, are reported to be associated with higher-quality inpatient care because of, among other things, closer adherence to guidelines. Co-management by hospitalists for patients with vertebral compression fractures has potential benefits towards improving the outcomes. We compared the rate of initiation of osteoporosis treatment for patients with vertebral compression fractures between conventional orthopedic surgeon-led care (conventional group) and hospitalist co-management care (co-management group). Methods: This is a single-center retrospective cohort study to evaluate the rate of initiation of osteoporosis treatment and reasons for non-initiation of osteoporosis treatment. Other clinical indicators were also evaluated, including length of hospital stay, preventable complications during hospitalization, and rate of 30-day readmission. Results: We identified 55 patients in the conventional group and 93 patients in the co-management group. The rate of initiation of osteoporosis treatment was higher in the co-management group (45.2% vs. 3.6%, OR 21.5; 95%CI 5.12-192.0; P < 0.01). Most of the patients with non-initiation in the co-management group had reasons for it described in the medical records, but in the conventional group the reasons were unknown. There was no significant difference in length of hospital stay, preventable complications during hospitalization, or 30-day readmission between the groups. Conclusions: Hospitalist co-management of patients with vertebral compression fractures showed significantly higher rate of initiation of osteoporosis treatment than conventional orthopedic surgeon-led care. Competing Interests: Declaration of competing interest None. (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
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