抄録
“Effects of critical pathways for hip fracture” was reviewed in11articles in 5 developed countries, published from 1993 to 2005. Critical pathway standardizes care and gives patients early ambulation, and reduced complication; consequently, in many cases, it reduces the length of stay (LOS) without degrading patients outcomes. Critical pathway sometimes increases LOS, if the original LOS was short, so that patients can take as much rehabilitation as needed in order to go home and walk independently. About 23 days is considered to be the possible minimum LOS, as long as the patient has regained ambulatory ability. It would be possible to safely reduce LOS to around 23 days in Japan as well, but it would be necessary to improve rehabilitation programs there, especially early ambulation and early walking exercise without limitation of weight-bearing, in order not to negatively affect outcomes at discharge. It is also necessary to observe the effect on patients' long-term outcomes after discharge, including mortality, readmission, ambulatory ability, and residence especially when LOS is reduced in Japan.
