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Differences in complications and length of stay between patients with a hip fracture treated in an orthopaedic department and patients treated in other hospital departments
Department of Health Sciences, Lund University.
Department of Health Sciences, Lund University.
Department of Orthopedics, Lund University Hospital.
Kristianstad University College, Department of Health Sciences.
2008 (English)In: Journal of Orthopaedic Nursing, ISSN 1361-3111, Vol. 12, no 1, 13-25 p.Article in journal (Refereed) Published
Abstract [en]

The health care system has to deal with substantial health care costs, which are expected to continue to rise due to increasingly elderly populations. One way of saving has been a reduction of the number of beds in hospitals. The consequence is that acute patients are inappropriately admitted to non-specialized wards because of limited beds. These patients are also known as ‘‘outliers’’. In this study, consecutive patients with a hip fracture treated at the orthopaedic department (n = 273) are compared with patients treated at other departments (n = 147) according to the incidence of complications and the length of stay (LOS) before and after the introduction of an evidence-based clinical pathway. There was no medical difference between the populations. However, the strict demands of saving costs, with limited beds, have resulted not only in economic consequences with prolonged hospitalization, but also in patient suffering and the inconvenience of increased postoperative complications.Patients treated at non-specialized wards had an extra LOS of 3.7 days in the acute hospital settings and furthermore, 13.6 days of LOS including rehabilitation compared to patients treated at the orthopaedic department. In addition, we consider the implemented evidence-based clinical pathway to be successful since the number of complications was reduced. It is a major challenge to establish effective treatment and rehabilitation for patients after a hip fracture aiming to avoid complications and reduce LOS. These fragile patients with a hip fracture ought to be treated at the orthopaedic department, or at departments with geriatric and rehabilitation knowledge. Physiotherapists, occupational therapists and nurses specialising in orthopaedics and geriatricians should take an active part in the care of these patients.

Place, publisher, year, edition, pages
2008. Vol. 12, no 1, 13-25 p.
Keyword
Hip fracture, length of stay, orthopaedic wards, specialized wards, clinical pathway, postoperative complications, outliers, rehabilitation
National Category
Surgery Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hkr:diva-162DOI: 10.1016/j.joon.2007.11.001OAI: oai:DiVA.org:hkr-162DiVA: diva2:159619
Available from: 2009-02-09 Created: 2009-02-09 Last updated: 2009-02-09Bibliographically approved

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CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
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  • asciidoc
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