Ortho-geriatric collaboration service in Kowloon Hospital

Introduction: Osteoporotic hip fracture is an increasing burden to the health care system in Hong Kong. Crossspecialty collaboration care has beneficial effect on clinical outcome. We aimed to evaluate an ortho-geriatric collaboration (OGC) service to improve the care of geriatric patients with oste...

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Bibliographic Details
Published in:	Asian journal of gerontology and geriatrics Vol. 15; no. 2; p. 100
Main Authors:	Siu, C Y, Yu, Teresa, Yeung, Eric M P, Lee, T H, Chin, Raymond, Cheng, William, Lee, K B, Li, Wilson, Ng, Pui Kin, Lau, Pui Pui, Chau, Rosanna, Cheung, Eddy, Ng, Bobby, To, Jess, Ting, Kwai Hing
Format:	Journal Article
Language:	English
Published:	Hong Kong Hong Kong Academy of Medicine 01-12-2020
Subjects:	Collaboration Fractures Geriatrics Length of stay Orthopedics Osteoporosis
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Summary:	Introduction: Osteoporotic hip fracture is an increasing burden to the health care system in Hong Kong. Crossspecialty collaboration care has beneficial effect on clinical outcome. We aimed to evaluate an ortho-geriatric collaboration (OGC) service to improve the care of geriatric patients with osteoporotic hip fracture. Methods: After a 1-year OGC pilot programme implemented in an orthopaedic ward from October 2018 to September 2019, the full OGC programme was implemented in October 2019 to cover all three orthopaedic wards (with 95 beds). A geriatrician would see all geriatric patients with fracture hip during regular morning rounds and provide comprehensive geriatric assessment, medical problems management, rehabilitation coordination, complications prevention, osteoporosis management, and discharge planning. Geriatric patients with hip fracture managed under the OGC programme and discharged between October 2019 and March 2020 (study group) were compared with geriatric patients with hip fracture discharged between January 2018 and September 2018 (control group). Results: We recruited 226 patients (67.3% female) [mean age, 84.79 years] in the study group and 247 patients (72% female) [mean age, 83.25 years] in the control group. The two groups were comparable in terms of age, sex, and residence. The mean length of hospital stay was shortened 22% in the study group from 34.4 days to 26.8 days (95% confidence intervals.85-10.44, p<0.005). The transfer back rate was 8% (21 of 247 discharge cases) in the control group and 13% (30 of 226 discharge cases) in the study group (p>0.05). In the study group, 52.6% of patients were given antiresorptive agents or referred to outpatient clinic for osteoporosis management. Conclusion: The OGC programme in Kowloon Hospital significantly shortened the length of hospital stay by 7.6 days (22%) in geriatric patients with fracture hip. The prescription of antiresorptive agents for osteoporosis was high (52.6%).
ISSN:	1819-1576 1819-1576