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Orthopaedic-geriatric models of care and their effectiveness

Authors

  • Carol P Chong,

    Corresponding author
    1. Department of Aged Care, The Northern Hospital, Epping; The Northern Clinical Research Centre, The Northern Hospital; and The Department of Medicine, Austin and Northern Health, The University of Melbourne, Melbourne, Victoria, Australia
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  • Judy Savige,

    1. The Northern Clinical Research Centre, The Northern Hospital; and The Department of Medicine, Austin and Northern Health, The University of Melbourne, Melbourne, Victoria, Australia
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  • Wen Kwang Lim

    1. Department of Aged Care, The Northern Hospital, Epping; The Northern Clinical Research Centre, The Northern Hospital; and The Department of Medicine, Austin and Northern Health, The University of Melbourne, Melbourne, Victoria, Australia
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  • There is no conflict of interest for any of the authors.

Dr Carol P Chong, Northern Clinical Research Centre, The Northern Hospital. Email: carol.chong@nh.org.au

Abstract

Different types of orthopaedic geriatric units have been established. This review evaluates the effectiveness of this model of care. A computerised literature search was undertaken using Medline (January 1966–February 2009), Cochrane and CINAHL with the search terms orthopaedics, geriatrics, aged, orthopaedic procedures and fractures. Relevant articles were evaluated and appraised with particular focus on randomised controlled trials. Orthopaedic-geriatric models can be divided according to the setting of care (i) acute inpatient orthopaedic-geriatric care; (ii) subacute rehabilitation; and (iii) community-based rehabilitation. Studies have been heterogenous in nature and outcomes measured have differed making pooled data analysis difficult. In general, there is a trend to effectiveness in outcomes such as functional recovery, length of stay, complications and mortality and importantly studies have not shown detrimental consequences. However, because of the varied types of interventions and models of care, it is difficult to draw firm conclusions about the effectiveness of these programs.

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