美国髋部骨折高级管理式医疗系统
Senior Managed Care System for Hip Fracture in the United States.
作者信息
Yazdanshenas Hamed, Washington Eleby R, Shamie Arya Nick, Madadi Firooz, Washington Eleby R
机构信息
Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.; Department of Family Medicine, University of California, Los Angles (UCLA), Los Angeles, CA, USA.; Department of Orthopaedic Surgery, University of California, Los Angles (UCLA), Los Angeles, CA, USA.
Department of Orthopaedic Surgery, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.
出版信息
Clin Orthop Surg. 2016 Mar;8(1):19-28. doi: 10.4055/cios.2016.8.1.19. Epub 2016 Feb 13.
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.
背景
在老年患者髋部骨折治疗中，管理式医疗模式是否会影响医疗质量和住院时间存在争议。
方法
本前瞻性研究旨在确定管理式医疗关键路径工具是否能缩短102例老年髋部骨折患者随访期间的住院时间。我们将研究结果与两组未采用重症监护路径治疗的老年髋部骨折患者的相应指标进行了比较。
结果
管理式医疗组死亡率为9%，95%的患者恢复到骨折前的生活状态，63%的患者恢复到可走动状态。这些比率优于先前的研究。关键路径前后提供的医疗质量相当，而路径实施后的住院时间缩短了30%。
结论
建议采用所提出的护理方案来缩短老年髋部骨折患者的住院时间。
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