PSH model reduces deaths, ED visits in elderly hip fracture patients

Editor's Note

Elderly hip fracture patients were less likely to die or return to the emergency department (ED) after discharge if they received care under the Perioperative Surgical Home (PSH) model of care, finds this study presented October 21 at the Anesthesiology 2017 annual meeting in Boston. PSH patients also were more likely to go home after discharge rather than to a rehabilitation facility.

The analysis included 222 hip fracture patients treated before PSH implementation and 118 who were treated after implementation. 

Death rates were reduced by half for the PSH group:

• 1.7% of non-PSH patients died in the hospital vs less than 1% of PSH patients.
• 3.2% of non-PSH patients died 30 days after discharge vs none of the PSH patients.
• 6.3% of non-PSH patients died 90 days after discharge vs 2.5% of PSH patients.

PSH patients were less likely to visit the ED after discharge:

• 9.5% of non-PSH patients visited the ED within 30 days after discharge vs 5.1% of PSH patients.
• 23.4% of non-PSH patients visited the ED within 90 days after discharge vs 14.4% of PSH patients.

PSH patients were much more likely to be discharged to their homes:

• 16.2% of non-PSH patients went directly home vs 40.7% of PSH patients.

The PSH has fundamentally changed the outcomes that matter to patients in this high-risk population, the authors say.

BOSTON - Elderly patients who had emergency repair of a fractured hip were much less likely to die or make a return visit to the emergency room (ER) after discharge if they received care under the Perioperative Surgical Home (PSH) model of care, suggests research presented at the ANESTHESIOLOGY® 2017 annual meeting.

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