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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, P.O. Box 157, SE-221 00 Lund, Sweden; Department of Orthopedics, Lund University Hospital, SE-221 85 Lund, Sweden.ORCID iD: 0000-0002-6114-6535
Department of Health Sciences, Lund University, P.O. Box 157, SE-221 00 Lund, Sweden.
Department of Orthopedics, Lund University Hospital, SE-221 85 Lund, Sweden.
Department of Health Sciences, Kristianstad University, SE-29188 Kristianstad, Sweden.
2008 (English)In: Journal of Orthopaedic Nursing, ISSN 1361-3111, E-ISSN 1873-4839, Vol. 12, no 1, p. 13-25Article 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
Elsevier, 2008. Vol. 12, no 1, p. 13-25
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:mau:diva-55943DOI: 10.1016/j.joon.2007.11.001OAI: oai:DiVA.org:mau-55943DiVA, id: diva2:1710283
Available from: 2022-11-11 Created: 2022-11-11 Last updated: 2022-11-24Bibliographically approved

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