Title

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

Publisher

Wiley

School

Nursing and Midwifery

RAS ID

24037

Comments

Originally published as: 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. Advance online publication. Original article available here

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

Not open access

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