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Senior Managed Care System for Hip Fracture in the United States
Hamed Yazdanshenas1, Eleby R Washington2, Arya Nick Shamie3
1Department 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.
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.
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