Effectiveness of regional clinical pathways on postoperative length of stay for hip fracture patients: A retrospective observational study using the Japanese Diagnosis Procedure Combination database

Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association
Yuko MineS Matsuda

Abstract

Regional clinical pathways, a new type of clinical pathway, are practiced with the aim of standardizing and optimizing medical care by cooperation among multiple medical institutions in a region. However, current evaluation of the effectiveness of regional clinical pathways for hip fracture, a major health problem requiring hospitalization for orthopedic surgery, is insufficient. This study aimed to determine the association between regional clinical pathways and postoperative hospital length of stay (LOS) among hip fracture patients. In particular, we focused on the variation in postoperative LOS of hip fracture patients among hospitals and the contribution of regional clinical pathways to this variation. Using data from the Diagnosis Procedure Combination (DPC) database in Japan from April 2011 to March 2013, patients who were diagnosed with "fracture of head and neck of femur" (ICD10 code S72.0) or "pertrochanteric fracture" (S72.1) and received "bipolar hip arthroplasty" or "open reduction and internal fixation" were extracted. A total of 110,133 patients were included. Associations between regional clinical pathways and postoperative LOS were analyzed using cross-sectional analysis with multilevel regression models. Hospit...Continue Reading

Citations

Feb 2, 2021·Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan·Shinobu Imai
Jul 22, 2021·Aging Clinical and Experimental Research·Antonio De VincentisUNKNOWN Istituto Superiore Sanità (ISS)
Sep 18, 2021·Critical Care : the Official Journal of the Critical Care Forum·Taro ImaedaKiyohide Fushimi

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