Abstract
As Japan moves into an aging society rapidly, the number of hip fractures continues to increase steadily. Therefore a liaison critical path for hip fracture treatment is already established widely in Japan to maintain a local healthcare system. 603 hip fractures were treated surgically at Ashikaga Red Cross Hospital over the peri od from January 2004 to May 2008, and the liaison critical path was applied to 26 hip fracture patients since November 2007.
In this study length of hospital stay and rate of home return were evaluated comparing the cases before and after the introduction of the liaison critical path. The length of hospital stay was 38 days before the introduction of the liaison critical path and the period was reduced to 32 days after the introduction. The rate of home return was 42.1% before the introduction and 33.7% afterwards. Since 31.5% of the patients were transferred to rehabilitation institutes afterwards, the real rate of home return is estimated at 65% after the introduction of the liaison critical path. Because 18 out of 144 patients, who were treated in 2007, were re-fractures, one important future issue for hip fractures is treatment of osteoporosis. The liaison critical path for osteoporosis treatment, which contains medical nutrition, medication and exercise therapy, is already established, but not yet widely in use due to low compliance of attending hospitals and clinics.
But we believe that the implementation of a local healthcare network combining the liaison critical path for osteoporosis treatment with the liaison critical path for hip fracture treatment could lead to a reduction of hip fractures.
