Borgquist L, Thorngren K G
Department of Community Health Sciences, Dalby, Sweden.
Acta Orthop Belg. 1994;60 Suppl 1:102-5.
During the past decades there has been an adaptation to the increasing number of hip fracture patients in the hospital as well as an adaptation to the economic conditions in society. Different ways of reducing hospitalization time have been applied. At the beginning of the 1950's all rehabilitation activities for hip fracture patients in Sweden were performed in hospital. The patients were confined to bed for approximately 4 months, and the mean hospital stay was more than 5 months at the Lund University Hospital. Because of fear of healing complications the nonweight-bearing period was very long. It was reduced from 4 months to 2 months during the 1950's and from 2 months to one month at the end of the 1960's. The efforts to optimize and rationalize hip fracture treatment have continued (16). The mean hospitalization time decreased from 44 days to 16 days between 1966 and 1982, and discharge home from the hospital increased from 44% to 75% for patients coming from home. In 1993 the mean hospital stay at the Lund University Hospital was 14 days. This reduction was an effect of strategy changes in the treatment of hip fractures and of changes in surgical techniques and the introduction of a rehabilitation program at home, in collaboration with primary health care facilities (1, 6, 7). Rehabilitation using primary health care resources has proved to be an efficient model when compared with the previous organization of rehabilitation of hip fracture patients in Sweden.
在过去几十年里，医院已适应髋部骨折患者数量的增加，同时也适应了社会经济状况。人们采用了不同方法来缩短住院时间。20世纪50年代初，瑞典所有髋部骨折患者的康复活动都在医院进行。患者需卧床约4个月，在隆德大学医院的平均住院时间超过5个月。由于担心愈合并发症，不负重期很长。在20世纪50年代，不负重期从4个月减至2个月，到60年代末又从2个月减至1个月。优化和合理化髋部骨折治疗的努力一直在持续（16）。1966年至1982年间，平均住院时间从44天降至16天，来自家中的患者出院回家的比例从44%增至75%。1993年，隆德大学医院的平均住院时间为14天。这种缩短是髋部骨折治疗策略改变、手术技术变化以及与初级卫生保健机构合作在家中引入康复计划的结果（1、6、7）。与瑞典之前髋部骨折患者的康复组织相比，利用初级卫生保健资源进行康复已被证明是一种有效的模式。
