نمایش مختصر رکورد

dc.contributor.authorVan Der Vliet, Quirine M. J.en_US
dc.contributor.authorWeaver, Michael J.en_US
dc.contributor.authorHeil, Kolomanen_US
dc.contributor.authorMcTague, Michael F.en_US
dc.contributor.authorHeng, Marilynen_US
dc.date.accessioned1399-10-19T15:37:54Zfa_IR
dc.date.accessioned2021-01-08T15:37:55Z
dc.date.available1399-10-19T15:37:54Zfa_IR
dc.date.available2021-01-08T15:37:55Z
dc.date.issued2021-01-01en_US
dc.date.issued1399-10-12fa_IR
dc.date.submitted2020-03-03en_US
dc.date.submitted1398-12-13fa_IR
dc.identifier.citationVan Der Vliet, Quirine M. J., Weaver, Michael J., Heil, Koloman, McTague, Michael F., Heng, Marilyn. (2021). Factors for Increased Hospital Stay and Utilization of Post -Acute Care Facilities in Geriatric Orthopaedic Fracture Patients. The Archives of Bone and Joint Surgery, 9(1), 70-78. doi: 10.22038/abjs.2020.46476.2276en_US
dc.identifier.issn2345-4644
dc.identifier.issn2345-461X
dc.identifier.urihttps://dx.doi.org/10.22038/abjs.2020.46476.2276
dc.identifier.urihttps://abjs.mums.ac.ir/article_16546.html
dc.identifier.urihttps://iranjournals.nlai.ir/handle/123456789/709553
dc.description.abstractBackground: This study aims to determine the extent of utilization of health care resources in the geriatric fracturepopulation and to identify factors associated with burden on resources.Methods: This is a retrospective study of 1074 patients ≥65 years admitted to an orthopaedic service for a long bonefracture between July 2014 - June 2015. Outcomes were hospital length of stay (LOS), discharge disposition, andpost-acute care facility LOS. Secondarily, readmission rates and mortality were assessed. Multivariable regression wasperformed to identify factors associated with utilization.Results: Prior to injury, 96% of patients lived at home and 50% ambulated independently. Median hospital LOS was5 days (IQR 3 – 7). 878 patients were discharged to a rehabilitation facility, with 45% being discharged <20 days.Ten percent of patients (n = 108) were re-admitted <90 days of their discharge. 924 patients were still alive oneyear after the injury. Higher Charlson Comorbidity Index (CCI) (P=0.048), male sex (P<0.001), pre-injury use of anambulatory device (P = 0.006), and undergoing surgical treatment (P<0.001) were associated with longer hospitalLOS. Older age (P<0.001), pre-injury ambulatory device (P=0.001), and surgery (P=0.012) were risk factors forrequiring discharge to another inpatient facility. Older age (P<0.001), pre-injury ambulatory aid (P<0.001), and preexistingimmobility (P<0.001) were independent risk factors for LOS >20 days in a rehabilitation facility. Dischargehome was not found to be associated with an increase in 1-year mortality after adjusting for age, CCI, sex, fracturelocation, and surgery (P=0.727). Shorter LOS in rehabilitation facilities (<20 days) was also not associated with anincrease in 1-year mortality (P=0.520).Conclusion: Elderly fracture patients utilize a significant amount of post-acute care resources and age, CCI, surgery,fracture location, pre-injury ambulatory status, and pre-injury living status were found to be associated with the use ofthese resources.Level of evidence: IIIen_US
dc.languageEnglish
dc.language.isoen_US
dc.publisherMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Associationen_US
dc.relation.ispartofThe Archives of Bone and Joint Surgeryen_US
dc.relation.isversionofhttps://dx.doi.org/10.22038/abjs.2020.46476.2276
dc.subjectbundled paymentsen_US
dc.subjectFractureen_US
dc.subjectGeriatricen_US
dc.subjecthealthcare utilizationen_US
dc.subjectLength of stayen_US
dc.subjectpost-acute careen_US
dc.subjectRehabilitationen_US
dc.titleFactors for Increased Hospital Stay and Utilization of Post -Acute Care Facilities in Geriatric Orthopaedic Fracture Patientsen_US
dc.typeTexten_US
dc.typeRESEARCH PAPERen_US
dc.contributor.department1 Harvard Medical School Orthopedic Trauma Initiative, Boston, MA, USA 2 University Medical Center Utrecht, Utrecht, Netherlandsen_US
dc.contributor.department1 Harvard Medical School Orthopedic Trauma Initiative, Boston, MA, USA 2Brigham and Women's Hospital, Department of Orthopedic Surgery, Boston, MA, USAen_US
dc.contributor.department1 Harvard Medical School Orthopedic Trauma Initiative, Boston, MA, USA 2Paracelsus Medical University, Salzburg, Austriaen_US
dc.contributor.department1 Harvard Medical School Orthopedic Trauma Initiative, Boston, MA, USA 2 Brigham and Women's Hospital, Department of Orthopedic Surgery, Boston, MA, USAen_US
dc.contributor.department1 Harvard Medical School Orthopedic Trauma Initiative, Boston, MA, USA 2 Massachusetts General Hospital, Department of Orthopaedic Surgery, Boston, MA, USAen_US
dc.citation.volume9
dc.citation.issue1
dc.citation.spage70
dc.citation.epage78
nlai.contributor.orcid0000-0001-5515-0952
nlai.contributor.orcid0000000240476818


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