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The value of an organized fracture program for the elderly: early results
Stephen L Kates1, Daniel A Mendelson, Susan M Friedman
1Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY, USA. stephen_kates@urmc.rochester.edu
Objectives:
To describe the early financial results of an organized hip fracture program for older adults.
Design:
Retrospective evaluation of financial data for a 1-year period on a hip fracture program for older adults.
Setting:
University medical center.
Patients:
All 193 adults older than age 60 with a native, nonpathologic hip fracture admitted to the hospital and surgically treated from May 2005 to April 2006 were included as subjects in this study.
Intervention:
The comanaged, protocol-driven fracture management program was used as the specific intervention for treating all patients with hip fractures.
Main Outcome Measure:
The primary outcome was profit or loss resulting from treatment of patients. Key quality measures studied included length of hospital stay, mortality rates, complication rates, and hospital readmission rates.
Results:
With use of an organized program, substantial savings in nearly all areas of expenditure is demonstrated. Adjusting for patient characteristics, costs are demonstrated to be 66.7% of the expected costs nationally. The length of stay, mortality, complication rates, and readmission rates were all noted to be below national averages.
Conclusions:
The improved quality measures suggest that better quality of patient care is associated with reduced costs.
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