Description of an orthopedic-geriatric model of care in Australia with 3 years data.
OBJECTIVE
Orthopedic-geriatric units have been established worldwide to improve the care of older patients admitted with fractures. This study describes one type of orthopedic-geriatric model which has been implemented in Victoria, Australia, named the Orthopedic Aged Care and Rehabilitation Service (OARS) and evaluates patient characteristics and outcomes including inpatient mortality.


METHODS
Eight hundred and thirty-four consecutive admissions under OARS between May 2003 and May 2006 were analyzed.


RESULTS
Mean age was 76.6 years, the majority of patients were female (73%) and had come from home (77%). Fractured neck of femur represented 51% of all fractures managed by OARS followed by lower limb fractures (20%) and upper limb fractures (13%). The majority of patients required inpatient rehabilitation (49% of patients overall and 61% specifically for fractured neck of femur). Inpatient mortality for all fractures was 2.5% and specifically 3.5% for fractured neck of femur.


CONCLUSIONS
The OARS model involves close liaison between orthopedic and geriatric teams and promotes a multidisciplinary approach. Mortality rate for fractured neck of femur was lower than the state average, suggesting that combined orthopedic-geriatric care can improve outcomes.
Chong
Carol
C
The Northern Hospital, Epping, Victoria, Australia. carol.chong@nh.org.au
Christou
Joanna
J
Fitzpatrick
Kylie
K
Wee
Rohan
R
Lim
Wen Kwang
WK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D005260:Female; D005265:Femoral Neck Fractures / Q000401:mortality* / Q000534:rehabilitation / Q000601:surgery; D005853:Geriatrics / Q000458:organization & administration*; D017052:Hospital Mortality; D006757:Hospital Units; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009985:Orthopedics / Q000458:organization & administration*; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration; D011446:Prospective Studies