Senior Managed Care System for Hip Fracture in the United States

Clin Orthop Surg. 2016 Mar;8(1):19-28. doi: 10.4055/cios.2016.8.1.19. Epub 2016 Feb 13.

Abstract

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.

Keywords: Aged; Hip fractures; Length of stay.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Hip Fractures / epidemiology*
  • Hip Fractures / mortality
  • Hip Fractures / therapy*
  • Humans
  • Length of Stay / statistics & numerical data*
  • Los Angeles / epidemiology
  • Male
  • Managed Care Programs / statistics & numerical data*
  • Middle Aged
  • Patient Readmission
  • Postoperative Complications
  • Prospective Studies
  • Quality of Health Care