title: The effectiveness of a multidisciplinary hip fracture care model in improving the clinical outcome and the average cost of manpower.
abstract: After the implementation of the multidisciplinary geriatric hip fracture clinical pathway in 2007, the hospital length of stay and the clinical outcomes improves. Moreover, the cost of manpower for each hip fracture decreases. It proves that this care model is cost-effective.
  
  
  
  The objective of this study is to compare the clinical outcomes and the cost of manpower before and after the implementation of the multidisciplinary geriatric hip fracture clinical pathway (GHFCP).
  
  
  
  The hip fracture data from 2006 was compared with the data of four consecutive years since 2008. The efficiency of the program is assessed using the hospital length of stay. The clinical outcomes include mortality rates and complication rates are compared. Cost of manpower was also analysed.
  
  
  
  After the implementation of the GHFCP, the preoperative length of stay shortened significantly from 5.8 days in 2006 to 1.3 days in 2011. The total length of stay in both acute and rehabilitation hospitals were also shortened by 6.1 days and 14.2 days, respectively. The postoperative pneumonia rate also decreased from 1.25 to 0.25%. The short- and long-term mortalities also showed a general improvement. Despite allied health manpower was increased to meet the increased workload, the shortened length of stay accounted for a mark decrease in cost of manpower per hip fracture case.
  
  
  
  This study proves that the GHFCP shortened the geriatric hip fracture patients' length of stay and improves the clinical outcomes. It is also cost-effective which proves better care is less costly.
authors.affiliation: Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, 102, Pokfulam Road, Pok Fu Lam, Hong Kong. catcherlau@gmail.com.
authors.forename: T W
authors.initials: TW
authors.lastname: Lau
authors.affiliation: Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, 102, Pokfulam Road, Pok Fu Lam, Hong Kong.
authors.forename: C
authors.initials: C
authors.lastname: Fang
authors.affiliation: Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, 102, Pokfulam Road, Pok Fu Lam, Hong Kong.
authors.forename: F
authors.initials: F
authors.lastname: Leung
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019091:Critical Pathways / Q000191:economics; D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000458:organization & administration*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006620:Hip Fractures / Q000191:economics / Q000401:mortality / Q000601:surgery*; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D017146:Models, Organizational; D058866:Osteoporotic Fractures / Q000191:economics / Q000401:mortality / Q000601:surgery*; D010348:Patient Care Team / Q000191:economics*; D010564:Personnel, Hospital / Q000191:economics; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Cost of care; Geriatric hip fracture; Mortality rates; Multidisciplinary