Clinical and Economic Value of Implementing a Geriatric Hip Fracture Program in Hospitals in the United States

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A geriatric fracture program (GFP) is a comprehensive hip fracture program within a hospital system that provides coordinated care with the goal of reducing surgical complications and mortality rates compared to fragmented care delivery provided by multiple practitioners. Surgery to repair a hip fracture places considerable stress on elderly patients, so a coordinated care approach is important in order to improve patient outcomes, such as reducing hospital length of stay, in-hospital complications, and mortality rates. The purpose of this research was to conduct a targeted review and evaluate the clinical and economic value of implementing a geriatric fracture program based on findings presented in the literature. PubMed was searched between the years of 2005 and 2020. In addition to published peer-reviewed literature, recent evidence from relevant trade journals and industry websites were identified using Google hand searched. Inclusion criteria were broad to avoid potential exclusion of relevant publications and grey literature. In total 18 articles from peer-reviewed journals were included as well as 6 grey literature articles. Studies showed statistically significant reductions in pressure sores, delirium, sepsis, pneumonia, in-hospital mortality, length of stay, and long-term mortality. Additionally, studies showed elderly hip fracture patients treated through a coordinated care program saw statistically significant improvements in mobility and quality of life as well as a higher rate of regaining independence. GFPs provided hospital systems not only an opportunity to improve patient outcomes but also to reduce costs. Implementing a GFP resulted in cost reductions in the acute care setting and provided a cost-effective solution for hospital systems that realized the full benefit of the GFP across the continuum of care in both the acute care and post-acute care settings. GFPs for treating hip fractures improved patient outcomes and reduced costs, thereby supporting hospital systems with their Triple Aim and value-based reimbursement strategies.



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