The Value of an Organized Fracture Program for the Elderly: Early Results

OBJECTIVES:To describe the early financial results of an organized hip fracture program for older adults. DESIGN:Retrospective evaluation of financial data for a 1-year period on a hip fracture program for older adults. SETTING:University medical center. PATIENTS:All 193 adults older than age 60 with a native, nonpathologic hip fracture admitted to the hospital and surgically treated from May 2005 to April 2006 were included as subjects in this study. INTERVENTION:The comanaged, protocol-driven fracture management program was used as the specific intervention for treating all patients with hip fractures. MAIN OUTCOME MEASURE:The primary outcome was profit or loss resulting from treatment of patients. Key quality measures studied included length of hospital stay, mortality rates, complication rates, and hospital readmission rates. RESULTS:With use of an organized program, substantial savings in nearly all areas of expenditure is demonstrated. Adjusting for patient characteristics, costs are demonstrated to be 66.7% of the expected costs nationally. The length of stay, mortality, complication rates, and readmission rates were all noted to be below national averages. CONCLUSIONS:The improved quality measures suggest that better quality of patient care is associated with reduced costs.