title: Integrated care pathway for hip fractures in a subacute rehabilitation setting.
abstract: BACKGROUND
  The effectiveness of integrated care pathways for hip fractures in subacute rehabilitation settings is not known. The study objective was to assess if a hip fracture integrated care pathway at a subacute rehabilitation facility would result in better functional outcomes, shorter length of stay and fewer institutionalisations.
  
  
  METHODS
  A randomised controlled trial on an integrated care pathway for hip fracture patients in a subacute rehabilitation setting. Modified Barthel Index, ambulatory status, SF-12, length of stay, discharge destination, hospital readmission and mortality were measured. Followup assessments were up to 1 year post-hip fracture.
  
  
  RESULTS
  There were no significant differences in Montebello Rehabilitation Factor Scores and proportions achieving premorbid ambulatory status at discharge, 6 months and 12 months respectively. There was a significant reduction in the median length of stay between the control group at 48.0 days and the intervention group at 35.0 days (P = 0.009). The proportion of readmissions to acute hospitals was similar in both groups up to 1 year. There were no significant differences for nursing home stay up to 1 year post-discharge and mortality at 1 year.
  
  
  CONCLUSIONS
  Our study supports the use of integrated care pathways in subacute rehabilitation settings to reduce length of stay whilst achieving the same functional gains.
authors.affiliation: Medical Division, St Luke's Hospital, Singapore.
authors.forename: Tsung Wei
authors.initials: TW
authors.lastname: Chong
authors.forename: Gribson
authors.initials: G
authors.lastname: Chan
authors.forename: Liang
authors.initials: L
authors.lastname: Feng
authors.forename: Susie
authors.initials: S
authors.lastname: Goh
authors.forename: Agnes
authors.initials: A
authors.lastname: Hew
authors.forename: Tze Pin
authors.initials: TP
authors.lastname: Ng
authors.forename: Boon Yeow
authors.initials: BY
authors.lastname: Tan
mesh_terms: D006620:Hip Fractures; D006801:Humans; D011446:Prospective Studies