title: Geriatric fracture center: a multidisciplinary treatment approach for older patients with a hip fracture improved quality of clinical care and short-term treatment outcomes.
abstract: OBJECTIVE
  Since April 1, 2008, patients aged ≥65 years presenting with a hip fracture at Ziekenhuisgroep Twente, Almelo (ZGT-A), The Netherlands, have been admitted to the geriatric fracture center (GFC) and treated according to the multidisciplinary treatment approach. The objective of this study was to evaluate how implementation of the treatment approach has influenced the quality of care given to older patients with hip fracture.
  
  
  METHODS
  Prospective cohort study with historical control group.
  
  
  METHODS
  Two groups of patients with hip fracture were compared, 1 group was treated according to the new multidisciplinary treatment approach in 2009-2010, and the other group received the usual treatment in 2007-2008. The number of readmissions within 30 days after discharge was compared, and an analysis was carried out regarding the number of complications, the number of consultations with various specialists and with the geriatrician, and the duration of hospital stay.
  
  
  RESULTS
  In all, 140 patients from 2009 to 2010 group and 90 patients from 2007 to 2008 group were included. In 2009-2010 group, the number of readmissions within 30 days dropped by 11 percentage points (P = .001). The incidence of the number of complications decreased with a median of 1 compared with 2007-2008 (P = .017) group. Delirium was diagnosed to be 6 percentage points more frequent. The median number of consultations with various specialists per patient decreased by 1 percentage point as a result of geriatrician cotreatment (P = .002). The median duration of hospital stay was 1 day shorter than that in 2007-2008 group.
  
  
  CONCLUSIONS
  The use of the multidisciplinary treatment approach led to a significant reduction in the number of readmissions within 30 days after discharge. It appears to be associated with improved short-term treatment outcomes for older patients with a hip fracture.
authors.affiliation: Department of Surgery, ZGT Almelo, The Netherlands.
authors.forename: E C Ellis
authors.initials: EC
authors.lastname: Folbert
authors.forename: Ruth S
authors.initials: RS
authors.lastname: Smit
authors.forename: Detlef
authors.initials: D
authors.lastname: van der Velde
authors.forename: E M Marlies
authors.initials: EM
authors.lastname: Regtuijt
authors.forename: M Hester
authors.initials: MH
authors.lastname: Klaren
authors.forename: J H Han
authors.initials: JH
authors.lastname: Hegeman
keywords: clinical pathway; elderly; geriatrician; hip fracture; multidisciplinary treatment