• Age and ageing · Jan 2016

    Can improved quality of care explain the success of orthogeriatric units? A population-based cohort study.

    • Pia Kjær Kristensen, Theis Muncholm Thillemann, Kjeld Søballe, and Søren Paaske Johnsen.
    • Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark Department of Orthopedic Surgery, Hospital Horsens, Horsens, Denmark.
    • Age Ageing. 2016 Jan 1; 45 (1): 66-71.

    Backgroundadmission to orthogeriatric units improves clinical outcomes for patients with hip fracture; however, little is known about the underlying mechanisms.Objectiveto compare quality of in-hospital care, 30-day mortality, time to surgery (TTS) and length of hospital stay (LOS) among patients with hip fracture admitted to orthogeriatric and ordinary orthopaedic units, respectively.Designpopulation-based cohort study.Measuresusing prospectively collected data from the Danish Multidisciplinary Hip Fracture Registry, we identified 11,461 patients aged ≥65 years admitted with a hip fracture between 1 March 2010 and 30 November 2011. The patients were divided into two groups: (i) those treated at an orthogeriatric unit, where the geriatrician is an integrated part of the multidisciplinary team, and (ii) those treated at an ordinary orthopaedic unit, where geriatric or medical consultant service are available on request. Outcome measures were the quality of care as reflected by six process performance measures, 30-day mortality, the TTS and the LOS. Data were analysed using log-binomial, linear and logistic regression controlling for potential confounders.Resultsadmittance to orthogeriatric units was associated with a higher chance for fulfilling five out of six process performance measures. Patients who were admitted to an orthogeriatric unit experienced a lower 30-day mortality (adjusted odds ratio (aOR) 0.69; 95% CI 0.54-0.88), whereas the LOS (adjusted relative time (aRT) of 1.18; 95% CI 0.92-1.52) and the TTS (aRT 1.06; 95% CI 0.89-1.26) were similar.Conclusionsadmittance to an orthogeriatric unit was associated with improved quality of care and lower 30-day mortality among patients with hip fracture.© The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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