Impact of hospitalist vs. non-hospitalist services on length of stay and 30-day readmission rate in hip fracture patients

• Published in: Hospital practice (1995) Vol. 47; no. 1; pp. 24 - 27
• Main Authors: Stephens, John R, Chang, Jamison W, Liles, E Allen, Adem, Mukhtar, Moore, Carlton
• Format: Journal Article
• Language: English
• Published: England 2019
• Subjects: Adult; Aged; Cohort Studies; Female; Health Services Research; Hip Fractures - surgery; Hip Fractures - therapy; Hospitalists; Humans; Length of Stay - statistics & numerical data; Male; Middle Aged; Patient Discharge - statistics & numerical data; Patient Readmission - statistics & numerical data; Retrospective Studies; co-management; hospital medicine; geriatrics; orthopedics; Hip fracture; perioperative medicine
• ISSN: 2154-8331; 2377-1003
• DOI: 10.1080/21548331.2019.1537850

Hip fracture is a common and morbid condition, affecting a patient population with significant medical co-morbidities. A number of medical co-management models have been studied, with conflicting reports of effect on patient outcomes. Our objective was to compare outcomes for patients with hip fracture managed by hospitalist vs. non-hospitalist services at an academic medical center.
We conducted a retrospective cohort study of patients with hip fracture over 1 year, comparing those on hospitalist vs. non-hospitalist services. Outcomes included 30-day readmission and hospitalization ≤7 days, with comparison between patients admitted to hospitalist vs. non-hospitalist services. We performed multivariate analysis, adjusting for age, gender, race/ethnicity, insurance type, ASA score, and blood transfusion during hospitalization and days from admission to surgery.
We identified 124 hospitalist and 53 non-hospitalist patients. In unadjusted analysis, hospitalist patients were more likely to have hospitalization ≤7 days (84.7% vs. 67.9%, p = 0.01). In adjusted analysis, hospitalist patients had lower odds of 30-day readmissions (OR 0.2, 95% CI 0.04-0.97) but no difference in odds of hospitalization ≤7 days (OR 2.1, 95% CI 0.82-5.66).
Patients with hip fracture managed by hospitalist vs. non-hospitalist services had lower odds of 30-day readmission after discharge. Our results suggest benefit to hospitalist co-management of hip fracture patients.