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哥伦比亚两机构老年骨折项目经验分析：可复制模式？

Analysis of the experience of the geriatric fracture program in two institutions in Colombia: a reproducible model?

机构信息

Fundación Santa Fe de Bogotá, Bogotá, Colombia.

Hospital Infantil Universitario de San José, Bogotá, Colombia.

出版信息

Colomb Med (Cali). 2021 Jun 12;52(3):e2034524. doi: 10.25100/cm.v52i3.4524. eCollection 2021 Jul-Sep.

DOI:10.25100/cm.v52i3.4524
PMID:35431358
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8973310/
Abstract

BACKGROUND

hip fracture is the major cause of morbidity and mortality. Geriatric fracture programs promise to improve the quality of care, health outcomes and reduce costs.

OBJECTIVE

To describe the results related to the Geriatric fracture programs implementation in two Colombian institutions to assess reproducibility.

METHODS

We performed A retrospective descriptive study of the patients treated under the Geriatric fracture programs in two institutions in Colombia. The information was collected from the initial year of implementation until 2018. Demographic characteristics, length of stay, hospitalization complications, readmissions and mortality were described. Consumption of healthcare resources was defined using base cases determined with local experts and costs were estimated using standard methods.

RESULTS

475 patients were included in the Geriatric fracture programs. We observed an increase in the number of patients. The length of stay decreased between 8.5% and 26.1% as did the proportion of total complications, with delirium having the greatest reduction. A similar situation was seen for first year mortality (from 10.9% to 4.7%), in-hospital deaths and readmissions. Estimates of costs of stay and complications showed reductions in all scenarios, varying between 22% and 68.3%.

CONCLUSIONS

The present study presents the experience of two institutions that implemented the Geriatric fracture programs with increase in the number of patients treated and reductions in the time of hospital stay, the proportion of complications, readmissions, mortality and estimated costs. These are similar between both institutions and with other published implementations. This could hint that geriatric fracture program may be implemented with reproducible results.

摘要

背景

髋部骨折是发病率和死亡率的主要原因。老年骨折计划有望提高护理质量、健康结果并降低成本。

目的

描述在哥伦比亚的两个机构实施老年骨折计划的结果，以评估其可重复性。

方法

我们对哥伦比亚的两个机构的老年骨折计划下治疗的患者进行了回顾性描述性研究。信息是从实施的初始年份收集到 2018 年的。描述了人口统计学特征、住院时间、住院并发症、再入院和死亡率。使用当地专家确定的基本病例来定义医疗保健资源的消耗，并使用标准方法来估计成本。

结果

475 名患者纳入老年骨折计划。我们观察到患者数量的增加。住院时间缩短了 8.5%至 26.1%，总并发症的比例也降低了，其中谵妄的减少幅度最大。同样，第一年的死亡率（从 10.9%降至 4.7%）、院内死亡和再入院也有所下降。所有情况下的住院和并发症费用估计都有所减少，降幅在 22%至 68.3%之间。

结论

本研究介绍了两个机构实施老年骨折计划的经验，治疗的患者数量增加，住院时间、并发症比例、再入院、死亡率和估计成本都有所减少。这两个机构之间以及与其他已发表的实施情况相似。这可能表明老年骨折计划的实施可以产生可重复的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/2b53e1a27fec/1657-9534-cm-52-03-e2034524-gf10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/26398435f449/1657-9534-cm-52-03-e2034524-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/a84eafc74f51/1657-9534-cm-52-03-e2034524-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/593917bee796/1657-9534-cm-52-03-e2034524-gf3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/933294888e82/1657-9534-cm-52-03-e2034524-gf4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/39549f1cf665/1657-9534-cm-52-03-e2034524-gf5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/02720d1faa1a/1657-9534-cm-52-03-e2034524-gf6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/46dc081eb91e/1657-9534-cm-52-03-e2034524-gf7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/111b70b2eab6/1657-9534-cm-52-03-e2034524-gf8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/1336c5c96cbf/1657-9534-cm-52-03-e2034524-gf9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/2b53e1a27fec/1657-9534-cm-52-03-e2034524-gf10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/26398435f449/1657-9534-cm-52-03-e2034524-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/a84eafc74f51/1657-9534-cm-52-03-e2034524-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/593917bee796/1657-9534-cm-52-03-e2034524-gf3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/933294888e82/1657-9534-cm-52-03-e2034524-gf4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/39549f1cf665/1657-9534-cm-52-03-e2034524-gf5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/02720d1faa1a/1657-9534-cm-52-03-e2034524-gf6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/46dc081eb91e/1657-9534-cm-52-03-e2034524-gf7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/111b70b2eab6/1657-9534-cm-52-03-e2034524-gf8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/1336c5c96cbf/1657-9534-cm-52-03-e2034524-gf9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6467/8973310/2b53e1a27fec/1657-9534-cm-52-03-e2034524-gf10.jpg

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