Impact of the orthopaedic nurse practitioner role on acute hospital length of stay and cost-savings for patients with hip fracture: A retrospective cohort study
Document Type
Journal Article
Publication Title
Journal of Advanced Nursing
Publisher
Wiley
School
School of Nursing and Midwifery
RAS ID
24037
Abstract
Aims: To compare acute hospital length of stay and cost-savings for patients with hip fracture before and after commencement of the Orthopaedic Nurse Practitioner and identify variables that increase length of stay in hospital.
Background: Globally, hip fractures are associated with significant morbidity and mortality. Whilst the practical benefits of the Orthopaedic Nurse Practitioner have been anecdotally shown, an analysis showing the cost-saving benefits has yet to be published.
Design: A retrospective cohort study.
Methods: Data from two population-based cohorts (2010, 2013) of hip fracture patients aged ≥65 years were extracted from the electronic hospital database at a large Western Australian tertiary metropolitan hospital. Multivariate linear regression was used to model factors affecting length of stay in hospital. A simple economic analysis was undertaken and cost-savings were estimated.
Results: For comparison (n = 354) and intervention (n = 301) groups, average age was 84 years and over 70% were female. Analyses showed length of stay was shorter in 2013 compared with 2010 (4.4–5.3 days). Shorter length of stay was associated with type of procedure and surgery within 24-hr and longer length of stay was associated with co-morbid conditions of pulmonary disease, congestive heart failure, dementia, anaemia on admission and complications of delirium, urinary tract infection, myocardial infarction and pneumonia. The cost-savings to the hospital over one year was $354,483 and the net annual cost-savings per patient was $1,178.
Conclusion: Implementation of the Orthopaedic Nurse Practitioner role for care of hip fracture patients can reduce acute hospital length of stay resulting in important cost-savings.
DOI
10.1111/jan.13330
Access Rights
subscription content
Comments
Coventry, L. L., Pickles, S., Sin, M., Towell, A., Giles, M., Murray, K., & Twigg, D. (2017). Impact of the orthopaedic nurse practitioner role on acute hospital length of stay and cost‐savings for patients with hip fracture: A retrospective cohort study. Journal of Advanced Nursing, 73(11), 2652-2663. https://doi.org/10.1111/jan.13330