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

Pia Kjær Kristensen; Theis Muncholm Thillemann; Kjeld Søballe; Søren Paaske Johnsen

doi:10.1093/ageing/afv155

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

Pia Kjær Kristensen
, Theis Muncholm Thillemann
, Kjeld Søballe
, Søren Paaske Johnsen

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

73 Citations (Scopus)

Abstract

BACKGROUND: admission to orthogeriatric units improves clinical outcomes for patients with hip fracture; however, little is known about the underlying mechanisms.

OBJECTIVE: to 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.

DESIGN: population-based cohort study.

MEASURES: using 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.

RESULTS: admittance 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.

CONCLUSIONS: admittance to an orthogeriatric unit was associated with improved quality of care and lower 30-day mortality among patients with hip fracture.

Original language	English
Article number	afv155
Journal	Age and Ageing
Volume	45
Issue	1
Pages (from-to)	66-71
Number of pages	6
ISSN	0002-0729
DOIs	https://doi.org/10.1093/ageing/afv155
Publication status	Published - 1 Jan 2016

Keywords

30-day mortality
Hip fracture
Length of stay
Older people
Orthogeriatric
Quality of care

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@article{9f6797f64b924ba9a9ab59bdbf77fff3,

title = "Can improved quality of care explain the success of orthogeriatric units?: A population-based cohort study",

abstract = "BACKGROUND: admission to orthogeriatric units improves clinical outcomes for patients with hip fracture; however, little is known about the underlying mechanisms.OBJECTIVE: to 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.DESIGN: population-based cohort study.MEASURES: using 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.RESULTS: admittance 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.CONCLUSIONS: admittance to an orthogeriatric unit was associated with improved quality of care and lower 30-day mortality among patients with hip fracture.",

keywords = "30-day mortality, Hip fracture, Length of stay, Older people, Orthogeriatric, Quality of care",

author = "Kristensen, \{Pia Kj{\ae}r\} and Thillemann, \{Theis Muncholm\} and Kjeld S{\o}balle and Johnsen, \{S{\o}ren Paaske\}",

year = "2016",

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doi = "10.1093/ageing/afv155",

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Can improved quality of care explain the success of orthogeriatric units? A population-based cohort study. / Kristensen, Pia Kjær; Thillemann, Theis Muncholm; Søballe, Kjeld et al.
In: Age and Ageing, Vol. 45, No. 1, afv155, 01.01.2016, p. 66-71.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Can improved quality of care explain the success of orthogeriatric units?

T2 - A population-based cohort study

AU - Kristensen, Pia Kjær

AU - Thillemann, Theis Muncholm

AU - Søballe, Kjeld

AU - Johnsen, Søren Paaske

PY - 2016/1/1

Y1 - 2016/1/1

N2 - BACKGROUND: admission to orthogeriatric units improves clinical outcomes for patients with hip fracture; however, little is known about the underlying mechanisms.OBJECTIVE: to 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.DESIGN: population-based cohort study.MEASURES: using 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.RESULTS: admittance 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.CONCLUSIONS: admittance to an orthogeriatric unit was associated with improved quality of care and lower 30-day mortality among patients with hip fracture.

AB - BACKGROUND: admission to orthogeriatric units improves clinical outcomes for patients with hip fracture; however, little is known about the underlying mechanisms.OBJECTIVE: to 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.DESIGN: population-based cohort study.MEASURES: using 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.RESULTS: admittance 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.CONCLUSIONS: admittance to an orthogeriatric unit was associated with improved quality of care and lower 30-day mortality among patients with hip fracture.

KW - 30-day mortality

KW - Hip fracture

KW - Length of stay

KW - Older people

KW - Orthogeriatric

KW - Quality of care

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DO - 10.1093/ageing/afv155

M3 - Journal article

C2 - 26582757

SN - 0002-0729

VL - 45

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JO - Age and Ageing

JF - Age and Ageing

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M1 - afv155

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