Variation in Treatment Patterns Correlate With Resource Utilization in the 30-Day Episode of Care of Displaced Femoral Neck Fractures
| Autor: | Zachary P. Berliner, H. John Cooper, Giles R. Scuderi, Andrew D. Olswing, Zenobia J. Brown, Matthew S. Hepinstall |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Arthroplasty Replacement Hip medicine.medical_treatment Episode of Care Comorbidity Patient Readmission Femoral Neck Fractures 03 medical and health sciences 0302 clinical medicine Internal medicine Odds Ratio medicine Humans Orthopedics and Sports Medicine Prospective Studies 030212 general & internal medicine Prospective cohort study Aged Retrospective Studies Aged 80 and over 030222 orthopedics Chi-Square Distribution business.industry Reproducibility of Results Retrospective cohort study Odds ratio Length of Stay Middle Aged medicine.disease Arthroplasty Hospitals Patient Discharge Hospitalization Orthopedic surgery Female Hemiarthroplasty business Chi-squared distribution |
| Zdroj: | The Journal of Arthroplasty. 33:S43-S48 |
| ISSN: | 0883-5403 |
| DOI: | 10.1016/j.arth.2018.01.008 |
| Popis: | BACKGROUND We evaluated which treatment decisions in the management of displaced femoral neck fractures (FNFs) may associate with measures of resource utilization relevant to a value-based episode-of-care model. METHODS A total of 1139 FNFs treated with hip arthroplasty at 7 hospitals were retrospectively reviewed. Treatment choices were procedure (hemiarthroplasty vs total hip arthroplasty [THA]), surgeon training status, admitting service, and time to surgery. Dependent variables were length of stay, discharge disposition, 30-day readmission, and in-hospital mortality. Variation across hospitals was evaluated with analysis of variance and chi-square tests. Treatment choices were evaluated for the dependent variables of interest with univariable and multivariable regression. RESULTS There was significant variation between hospitals regarding proportion of cases treated with THA (range = 3.0%-73.2%, P < .001), proportion treated by arthroplasty fellowship-trained surgeons (range = 0%-74.9%, P < .001), proportion admitted to the orthopedic service (range = 2.8%-91.3%, P |
| Databáze: | OpenAIRE |
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