The Nottingham Orthogeriatric unit after 1000 admissions

Boyd, R. V.; Hawthorne, J. N.; Wallace, W. A.; Worlock, P; Compton, Edward

doi:10.1016/0020-1383(83)90013-x

Cited by 45 publications

(29 citation statements)

References 1 publication

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“…The economic advantages gained by transferring postoperative rehabilitation to the geriatric department are thus largely a matter of accounting. Several studies show a shortened hospital stay when elderly hip fracture patients are treated in specialized geriatric rehabilitation units (Boyd et al 1983, Sainsbury et al 1986, Murphy et al 1987, Kennie et al 1988, Hempsall et al 1990, ZidCn et al 1990). The results, however, are usually compared with historic data and patient selection probably occurs.…”

Section: Discussionmentioning

confidence: 99%

Prospective payment systems and hip fracture treatment costs

Strömberg

Öhlén

Svensson

1997

Acta Orthopaedica Scandinavica

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Section: Discussionmentioning

confidence: 99%

Prospective payment systems and hip fracture treatment costs

Strömberg

Öhlén

Svensson

1997

Acta Orthopaedica Scandinavica

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“…Study design and characteristics Table 1 lists the methodological elements and outcomes of the 21 papers included, whereas eight were prospective randomized studies [6][7][8][9][10][11][12][13], nine were prospective cohort studies with different (retrospective) control groups [1,[14][15][16][17][18][19][20][21], and four were retrospective chart reviews [22][23][24][25].…”

Section: Study Selectionmentioning

confidence: 99%

“…In the third group, there were five citations [9,10,20,22,24]. One was a before and after study [22], two [9,10] were prospective randomized with a "usual care" control group, one was a consecutive cohort study with quasi-randomization by availability of beds [26], and one was a retrospective chart review [24].…”

Section: Geriatric Rehabilitation Ward and Orthopedic Consultant Servicementioning

confidence: 99%

“…One was a before and after study [22], two [9,10] were prospective randomized with a "usual care" control group, one was a consecutive cohort study with quasi-randomization by availability of beds [26], and one was a retrospective chart review [24]. One investigation did only include medically stable patients [26], and another study excluded bedridden patients and patients with severe hip osteoarthritis or severe renal failure [10].…”

Section: Geriatric Rehabilitation Ward and Orthopedic Consultant Servicementioning

confidence: 99%

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Ortho-geriatric service—a literature review comparing different models

et al. 2010

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In the fast-growing geriatric population, we are confronted with both osteoporosis, which makes fixation of fractures more and more challenging, and several comorbidities, which are most likely to cause postoperative complications. Several models of shared care for these patients are described, and the goal of our systematic literature research was to point out the differences of the individual models. A systematic electronic database search was performed, identifying articles that evaluate in a multidisciplinary approach the elderly hip fracture patients, including at least a geriatrician and an orthopedic surgeon focused on in-hospital treatment. The different investigations were categorized into four groups defined by the type of intervention. The main outcome parameters were pooled across the studies and weighted by sample size. Out of 656 potentially relevant citations, 21 could be extracted and categorized into four groups. Regarding the main outcome parameters, the group with integrated care could show the lowest in-hospital mortality rate (1.14%), the lowest length of stay (7.39 days), and the lowest mean time to surgery (1.43 days). No clear statement could be found for the medical complication rates and the activities of daily living due to their inhomogeneity when comparing the models. The review of these investigations cannot tell us the best model, but there is a trend toward more recent models using an integrated approach. Integrated care summarizes all the positive features reported in the various investigations like integration of a Geriatrician in the trauma unit, having a multidisciplinary team, prioritizing the geriatric fracture patients, and developing guidelines for the patients' treatment. Each hospital implementing a special model for geriatric hip fracture patients should collect detailed data about the patients, process of care, and outcomes to be able to participate in audit processes and avoid peerlessness.

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“…Units that have been established and have reported favorable results include those of Hastings, England (Campbell 1976), Nottingham, England (Boyd et al 1983), Christchurch, New Zealand (Sainsbury et al I986), Islington, England (Murphy et al 1987), and Boumemouth, England (Hempsall 1990). These reports were purely descriptive of the organization and results of treatment.…”

Section: Discussionmentioning

confidence: 99%