title: Comprehensive care program for elderly patients over 65 years with hip fracture.
abstract: OBJECTIVE
  To report the health outcomes of a multidisciplinary care program for patients over 65 years with hip fracture.
  
  
  METHODS
  We have developed a care coordination model for the comprehensive care of hip fracture patients. It establishes what, who, when, how and where orthopedists, internists, family physicians, emergency, intensive care, physiotherapists, anesthetists, nurses and workers social intervene. All elderly patients over 65 years admitted with the diagnosis of hip fracture (years 2006 to 2010) were retrospectively evaluated.
  
  
  RESULTS
  One thousand episodes of hip fracture, corresponding to 956 patients, were included. Mean age was 82 years and mean stay 6.7 days. This was reduced by 1.14 days during the 5 years of the program. A total of 85.1% were operated on before 72 yours, and 91.2% during the program. Incidence of surgical site infection was 1.5%. In-hospital mortality was 4.5%, (24.2% at 12 months). Readmissions at one years was 14.9%. Independence for basic activity of daily living was achieved by 40% of the patients.
  
  
  CONCLUSIONS
  This multidisciplinary care program for hip fracture patients is associated with positive health outcomes, with a high percentage of patients treated early (more than 90%), reduced mean stay (less than 7 days), incidence of surgical site infections, readmissions and inpatient mortality and at one year, as well as adequate functional recovery.
authors.affiliation: Servicio de Medicina Interna, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España. Electronic address: antonio.fernandez@sjd.es.
authors.forename: A
authors.initials: A
authors.lastname: Fernández-Moyano
authors.affiliation: Servicio de Medicina Interna, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España.
authors.forename: R
authors.initials: R
authors.lastname: Fernández-Ojeda
authors.affiliation: Departamento de Calidad Asistencial, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España.
authors.forename: V
authors.initials: V
authors.lastname: Ruiz-Romero
authors.affiliation: Servicio de Traumatología y Ortopedia, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España.
authors.forename: B
authors.initials: B
authors.lastname: García-Benítez
authors.affiliation: Servicio de Medicina Interna, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España.
authors.forename: C
authors.initials: C
authors.lastname: Palmero-Palmero
authors.affiliation: Servicio de Medicina Interna, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España.
authors.forename: R
authors.initials: R
authors.lastname: Aparicio-Santos
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000473:pathology / Q000534:rehabilitation* / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D010348:Patient Care Team; D020127:Recovery of Function; D012189:Retrospective Studies
keywords: Atención multidisciplinar; Estancia media; Fractura de cadera del anciano; Hip fracture; Interdisciplinary care; Internal Medicine; Length of stay; Medicina Interna; Mortalidad; Mortality; Patient readmissions; Reingresos