BACKGROUND: The optimal setting and design of care for elderly patients with hip fracture is unknown. North Shore Hospital (NSH) and Middlemore Hospital (MMH) are two major hospitals in the Auckland region operating different models of orthogeriatric care. The aim of the study was to compare hip fracture care between NSH and MMH. METHODS: A retrospective case record audit of patients aged 65 years and older with hip fracture from July to December 2004 at MMH and NSH was carried out. RESULTS: Charts for 203 patients (101 MMH and 102 NSH) were reviewed. The two groups were similar in age (mean age 83.2 years), sex (80% women) and other casemix factors. Median time from admission to theatre was shorter in NSH (21 vs 44 h, P < 0.0001). Length of stay was significantly shorter at NSH (mean difference 4.4 days, 95% confidence interval 1.1-7.6 when adjusted for casemix factors). Significantly more NSH patients were transferred for rehabilitation than MMH patients (75 vs 51%). At discharge, significantly more MMH patients (34 vs 14%) were treated with alendronate. Of 126 patients admitted from home, 81% returned home, 4% went to rest homes, 13% to private hospitals and 2% died; differences between centres were not significant. Overall inpatient mortality was 3.9%. CONCLUSION: The orthogeriatric model of care at NSH was associated with a shorter overall length of stay, earlier transfer to the Assessment, Treatment and Rehabilitation setting, and a higher proportion rehabilitated in Assessment, Treatment and Rehabilitation. Outcomes in terms of discharge destination and 6-month mortality were similar at both centres.
BACKGROUND: The optimal setting and design of care for elderly patients with hip fracture is unknown. North Shore Hospital (NSH) and Middlemore Hospital (MMH) are two major hospitals in the Auckland region operating different models of orthogeriatric care. The aim of the study was to compare hip fracture care between NSH and MMH. METHODS: A retrospective case record audit of patients aged 65 years and older with hip fracture from July to December 2004 at MMH and NSH was carried out. RESULTS: Charts for 203 patients (101 MMH and 102 NSH) were reviewed. The two groups were similar in age (mean age 83.2 years), sex (80% women) and other casemix factors. Median time from admission to theatre was shorter in NSH (21 vs 44 h, P < 0.0001). Length of stay was significantly shorter at NSH (mean difference 4.4 days, 95% confidence interval 1.1-7.6 when adjusted for casemix factors). Significantly more NSH patients were transferred for rehabilitation than MMH patients (75 vs 51%). At discharge, significantly more MMH patients (34 vs 14%) were treated with alendronate. Of 126 patients admitted from home, 81% returned home, 4% went to rest homes, 13% to private hospitals and 2% died; differences between centres were not significant. Overall inpatient mortality was 3.9%. CONCLUSION: The orthogeriatric model of care at NSH was associated with a shorter overall length of stay, earlier transfer to the Assessment, Treatment and Rehabilitation setting, and a higher proportion rehabilitated in Assessment, Treatment and Rehabilitation. Outcomes in terms of discharge destination and 6-month mortality were similar at both centres.
Authors: Kristen B Pitzul; Sarah E P Munce; Laure Perrier; Lauren Beaupre; Suzanne N Morin; Rhona McGlasson; Susan B Jaglal Journal: BMJ Open Date: 2017-03-21 Impact factor: 2.692
Authors: Christine Ellen Gill; Paul James Mitchell; Jan Clark; Jillian Cornish; Peter Fergusson; Nigel Gilchrist; Lynne Hayman; Sue Hornblow; David Kim; Denise Mackenzie; Stella Milsom; Adrienne von Tunzelmann; Elizabeth Binns; Kim Fergusson; Stewart Fleming; Sarah Hurring; Rebbecca Lilley; Caroline Miller; Pierre Navarre; Andrea Pettett; Shankar Sankaran; Min Yee Seow; Jenny Sincock; Nicola Ward; Mark Wright; Jacqueline Clare Therese Close; Ian Andrew Harris; Elizabeth Armstrong; Jamie Hallen; Joanna Hikaka; Ngaire Kerse; Andrea Vujnovich; Kirtan Ganda; Markus Joachim Seibel; Thomas Jackson; Paul Kennedy; Kirsten Malpas; Leona Dann; Carl Shuker; Colleen Dunne; Philip Wood; Jay Magaziner; David Marsh; Irewin Tabu; Cyrus Cooper; Philippe Halbout; Muhammad Kassim Javaid; Kristina Åkesson; Anastasia Soulié Mlotek; Eric Brûlé-Champagne; Roger Harris Journal: Arch Osteoporos Date: 2022-08-02 Impact factor: 2.879
Authors: Bastiaan Van Grootven; Lynn McNicoll; Daniel A Mendelson; Susan M Friedman; Katleen Fagard; Koen Milisen; Johan Flamaing; Mieke Deschodt Journal: BMJ Open Date: 2018-03-16 Impact factor: 2.692