The Development of Seamless Service System Model for Elderly with Hip Fracture in Yasothon Health Service Network, Yasothon Province
Keywords:
Elderly, Hip Fracture, SeamlessAbstract
Background: As hip fractures among the elderly continue to rise, it is essential to develop an effective treatment system to support these patients in recovering their autonomy. Objective: To develop and study the effectiveness of a seamless care model for elderly patients with hip fractures in the Yasothon Province healthcare network. Methods: This is a research and development study involving 1) 20 healthcare providers who developed the care model, and 2) elderly patients who underwent hip fracture surgery between September and December 2024. Data were collected using a data recording form and a questionnaire with a reliability coefficient of 0.93. Data were analyzed using descriptive statistics and inferential statistics with paired sample t-test. Results: The seamless care model for elderly hip fracture patients consisted of 3 components: Pre-hospital care-Prevention and quality referral systems to reduce the risk of hip fractures. In-hospital care-Timely surgical intervention through the hip fast track surgery system with clinical examinations and online medication management for treatment planning. Post-hospital care- home visits and telemedicine follow-ups for six months after discharge. After receiving care through the system, the majority of patients (63.60%) had a hospital stay of 5-9 days. Post-surgery pain levels decreased continuously, with no complications (88.60%), and there were statistically significant improvements in daily living activities (p-value = .026), overall quality of life (p-value < .001), and physical and mental health (p-value < .001, p-value = .015). Conclusion: The seamless care system for elderly hip fracture patients with hip fractures helps timely surgical treatment, reduces postoperative complications, shortens the length of hospital stay, enables patients to perform daily activities independently, and improves their quality of life.
References
Roberts KC, Brox WT, Jevsevar DS, Sevarino K. Management of hip fractures in the elderly. J Am Acad Orthop Surg 2015;23(2):131-7.
Parker M, Johansen A. Hip fracture. BMJ 2006;333(7557):27-30.
Gullberg B, Johnell O, Kanis JA. World-wide projections for hip fracture. Osteoporos Int 1997;7(5):407-13.
Harty JA, McKenna P, Moloney D, D'Souza L, Masterson E. Anti-platelet agents and surgical delay in elderly patients with hip fractures. J Orthop Surg (Hong Kong) 2007;15(3):270-2.
Abeygunasekara T, Lekamwasam S, Lenora J, Alwis G. Quality of life and functional independence of hip fracture patients: data from a single center follow-up study in Sri Lanka. Ann Geriatr Med Res 2021;25(2): 98-104.
Yusuwan K. A comparison of the success rate of surgery in the first 48 hours and other complications between the traditional care and the fast-track surgery in patients with hip fracture, Chaophraya Yommarat Hospital. Singburi Hosp J 2021;30(2):39-52.
Klestil T, Röder C, Stotter C, Winkler B, Nehrer S, Lutz M, et al. Impact of timing of surgery in elderly hip fracture patients: a systematic review and meta-analysis. Sci Rep 2018;8(1):13933.
Yaron N, Kuniavsky M, Alexander K, Olga B, Nethanel G, Shuli H, et al. Performing hip fracture repair within 48 hours from admission may decrease mortality, the Israeli National Program for quality indicators experience. J Geriatr Med Gerontol 2021;7(2):1-4.
Simunovic N, Devereaux PJ, Sprague S, Guyatt GH, Schemitsch E, DeBeer J, et al. Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysis. CMAJ 2010;182(15):1609-16.
Seong YJ, Shin WC, Moon NH, Suh KT. Timing of hip-fracture surgery in elderly patients: literature review and recommendations. Hip Pelvis 2020;32(1):11-6.
Poh KS, Lingaraj K. Complications and their risk factors following hip fracture surgery. J Orthop Surg (Hong Kong) 2013;21(2):154-7.
Mahatnirunkul S, Tuntipivatanakul W, Pumpisanchai W, Wongsuwan K, Ponmanajirangkul R. Comparison of the WHOQOL-100 and the WHOQOL-BREF (26 items). Chiangmai: Suanprung Hospital Chiangmai; 1998.
Meehanpong P, Boonsin S, Baiteang C. Development of an early surgery nursing service system for the older patients with hip fracture in Sing Buri Hospital. NJPH 2023;33(1):147-60.
Meehanpong P, Boonsin S, Baiteang C. Development of clinical nursing practice guideline for elderly patients with undergoing total hip arthroplasty by evidence-Based pactice in Sing Buri Hospital. JND 2023;50(2):1-15.
Nipudjakarnsoonthorn U, Kanyakan K. Evaluation of the implementation of further development to expand the community health system model to a seamless health service system for the elderly, Ubon Ratchathani Province. J pub health innov phcsuphan 2024;4(3):1-15.
Baitiang C. A comparison of Activities of Daily Living (ADL) in patients with fragility hip fractures undergoing surgery within 48 hours versus after 48 hours. Singburi Hosp J 2023;32(1):B113-24.
Khan SK, Kalra S, Khanna A, Thiruvengada MM, Parker MJ. Timing of surgery for hip fractures: a systematic review of 52 published studies involving 291,413 patients. Injury 2009;40(7):692-7.
Chalanuwat C, Samrit K, Thongtanunam Y, Samartkit N. Development of a clinical nursing practice guideline for hip fracture patients undergoing internal fixation surgery at Buddhasothorn Hospital, Chachoengsao. JFONUBUU 2021;29(4):34-46.
Sanpunya T, Intayos H, Jarkthong S. Effects of an empowerment program on caregivers of older adults undergoing hip fracture surgery, Phare Hospital. J Nurs Public Health Res 2023;3(1):33-48.
Voshaar RC, Banerjee S, Horan M, Baldwin R, Pendleton N, Proctor R, et al. Fear of falling more important than pain and depression for functional recovery after surgery for hip fracture in older people. Psychol Med 2006;36(11):1635-45.
Meeprasert T. Quality of life at preoperative and postoperative period of hip surgery in older patients with hip fracture. [Thesis]. Nakhon Pathom: Mahidol University; 2007.
Haddad Bl, Abu Ali M, Alashkar O, Jamos D, Alnaser I, Qambar O, et al. Quality of life after hip fracture surgery in the elderly: a cross-sectional study. Cureus 2024;16(1):e52631.
Simunovic N, Devereaux PJ, Sprague S, Guyatt GH, Schemitsch E, DeBeer J, et al. Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysis. CMAJ 2010;182(15): 1609-16.
Klestil T, Röder C, Stotter C, Winkler B, Nehrer S, Lutz M, et al. Impact of timing of surgery in elderly hip fracture patients: a systematic review and meta-analysis. Sci Rep 2018;8(1):13933.
Meehanpong P, Boonsin S, Roojanavech S, Chatdokmaiprai K. Factors affecting complication in the older patients after hip surgery in Singburi Hospital. MKHJ 2022;19(2):77-87.
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