1.Senior Managed Care System for Hip Fracture in the United States.
Hamed YAZDANSHENAS ; Eleby R WASHINGTON ; Arya Nick SHAMIE ; Firooz MADADI ; Eleby R WASHINGTON
Clinics in Orthopedic Surgery 2016;8(1):19-28
BACKGROUND: It is debatable whether a managed care model would affect the quality of care and length of hospital stay in the treatment of hip fractures in elderly patients. METHODS: This prospective study was undertaken to determine whether or not a managed care critical pathway tool shortened hospital stay in a group of 102 senior patients with fractures of the hip during follow-up. We compared our study findings with two equivalent populations of senior hip fracture patients not treated using a critical care pathway concerning specific markers of quality. RESULTS: The managed care group had a 9% mortality rate, 95% return to prefracture living and 63% return to ambulatory status. The rates compared favorably with previous studies. The quality of care provided before and after the critical pathway was equivalent, while the post-pathway length of stay dropped 30%. CONCLUSIONS: The proposed care protocol is recommended to shorten hospital stay in elderly patients with hip fractures.
Aged
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Aged, 80 and over
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Female
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Hip Fractures/*epidemiology/mortality/*therapy
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Humans
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Length of Stay/*statistics & numerical data
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Los Angeles/epidemiology
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Male
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Managed Care Programs/*statistics & numerical data
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Middle Aged
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Patient Readmission
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Postoperative Complications
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Prospective Studies
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Quality of Health Care