title: Senior Managed Care System for Hip Fracture in the United States.
abstract: BACKGROUND
  It is debatable whether a managed care model would affect the quality of care and length of hospital stay in the treatment of hip fractures in elderly patients.
  
  
  METHODS
  This prospective study was undertaken to determine whether or not a managed care critical pathway tool shortened hospital stay in a group of 102 senior patients with fractures of the hip during follow-up. We compared our study findings with two equivalent populations of senior hip fracture patients not treated using a critical care pathway concerning specific markers of quality.
  
  
  RESULTS
  The managed care group had a 9% mortality rate, 95% return to prefracture living and 63% return to ambulatory status. The rates compared favorably with previous studies. The quality of care provided before and after the critical pathway was equivalent, while the post-pathway length of stay dropped 30%.
  
  
  CONCLUSIONS
  The proposed care protocol is recommended to shorten hospital stay in elderly patients with hip fractures.
authors.affiliation: Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.; Department of Family Medicine, University of California, Los Angles (UCLA), Los Angeles, CA, USA.; Department of Orthopaedic Surgery, University of California, Los Angles (UCLA), Los Angeles, CA, USA.
authors.forename: Hamed
authors.initials: H
authors.lastname: Yazdanshenas
authors.affiliation: Department of Orthopaedic Surgery, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.
authors.forename: Eleby R
authors.initials: ER
authors.lastname: Washington
authors.affiliation: Department of Orthopaedic Surgery, University of California, Los Angles (UCLA), Los Angeles, CA, USA.
authors.forename: Arya Nick
authors.initials: AN
authors.lastname: Shamie
authors.affiliation: Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran.
authors.forename: Firooz
authors.initials: F
authors.lastname: Madadi
authors.affiliation: Department of Orthopaedic Surgery, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.
authors.forename: Eleby R
authors.initials: ER
authors.lastname: Washington
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data*; D008875:Middle Aged; D010359:Patient Readmission; D011183:Postoperative Complications; D011446:Prospective Studies; D011787:Quality of Health Care
keywords: Aged; Hip fractures; Length of stay