Older Chinese patients with fragility hip fracture in Hong Kong: calling for focused ortho-geriatric co-care
| Autor: | Simon Kwoon-Ho Chow, Hon-Ming Ma, Qi Ding, Louis Wing-Hoi Cheung, Kwok-Sui Leung |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Hip fracture
medicine.medical_specialty Population ageing Standard of care Leadership and Management business.industry Strategy and Management Health Policy Hip fracture surgery Retrospective cohort study medicine.disease Service model Health Information Management Older patients medicine Physical therapy business Surgical treatment |
| Zdroj: | Journal of Hospital Management and Health Policy. 3:19-19 |
| ISSN: | 2523-2533 |
| DOI: | 10.21037/jhmhp.2019.06.06 |
| Popis: | Background: Orthogeriatric co-management is the standard of care of hip fracture. Methods: This retrospective study aimed to evaluate the differences of clinical characteristics and outcomes of older patients (aged ≥50 years) hospitalised for hip fracture in six public hospitals in Hong Kong in 2012. They were categorized into three groups based on their need for peri-operative medical optimization: inputs from geriatricians (Group 1), inputs from general physicians (Group 2) and no need for medical inputs (Group 3). We compared their clinical characteristics, surgical treatment and short-term outcomes. Results: In total, 2,748 patients were analyzed. Compared with patients of Group 3 (n=1,322), those of Group 1 (n=422) and 2 (n=1,004) were slightly older, less able to walk independently and more likely to have pressure ulcer on admission. They also had higher peri-operative risk (American Society of Anesthesiologist Grade ≥3) with a larger number of comorbidities. Group 3 had the largest proportion (72.7%) of patients who had early surgical treatment ( Conclusions: The demand for peri-operative medical optimization in older patients undergoing hip fracture surgery was very huge. We may re-engineer the existing service model in view of ageing population. Group 3 represented a distinct group of healthier patients who can be managed by a nurse-led approach. |
| Databáze: | OpenAIRE |
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