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Introduction <p>Patients admitted for hip fracture surgery may receive care from a team led either by the operating surgeon or a hospitalist.</p> Objective <p>To describe the prevalence of the hospitalist care model for hip fracture admissions and its association with patient outcomes.</p> Design <p>We conducted a retrospective cohort study of patients admitted in 2018–2019 for fracture of the head and neck of the femur (ICD10 S72.0x-2x). We compared outcomes at hospitals with low versus high use of the hospitalist care model. Our exposure was the hospital-level adoption of hospitalist care, categorized into quartiles.</p> Participants <p>Fee-for-service Medicare patients 66&#xa0;years old or greater.</p> Main Measures <p>Length of stay (LOS), professional services (Part B) inpatient spending, specialty consultation, discharge to home, all-cause 7- and 30-day readmissions, and 30-day mortality.</p> Key Results <p>A total of 294,150 patients with hip fracture were admitted to 2466 hospitals. Patients cared for in low-use (Q1) versus high-use (Q4) hospitals did not differ meaningfully in demographic characteristics or comorbidities. Hospitals ranged in use of the hospitalist care model from 12% in low-use (Q1) hospitals to 81% in high-use (Q4) hospitals. Low-use hospitals had significantly higher inpatient consult use (unadjusted: Q1 vs Q4, 1.06 vs 0.63 consults, <i>p</i> &lt; 0.0001; adjusted: −0.36, <i>p</i> &lt; 0.001) and length of stay (unadjusted: Q1 vs Q4, 6.04 vs 5.94&#xa0;days, <i>p</i> &lt; 0.0001; adjusted: −0.09&#xa0;days, <i>p</i> &lt; 0.05), but no significant difference in adjusted analyses for spending, likelihood of discharge home, 7- and 30-day readmission, or 30-day mortality.</p> Conclusions <p>Hospitalist care for older adults admitted for hip fracture surgery is both common and associated with slightly shorter length of stay.</p>

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Association of Hospitalist Co-management and Patient Outcomes with Patients Hospitalized for Hip Fracture

  • 期刊论文

  • 发表日期：

    2026年2月2日

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  • Jennifer P. Stevens,
  • Laura A. Hatfield,
  • David J. Nyweide,
  • Bruce Landon

摘要

Introduction

Patients admitted for hip fracture surgery may receive care from a team led either by the operating surgeon or a hospitalist.

Objective

To describe the prevalence of the hospitalist care model for hip fracture admissions and its association with patient outcomes.

Design

We conducted a retrospective cohort study of patients admitted in 2018–2019 for fracture of the head and neck of the femur (ICD10 S72.0x-2x). We compared outcomes at hospitals with low versus high use of the hospitalist care model. Our exposure was the hospital-level adoption of hospitalist care, categorized into quartiles.

Participants

Fee-for-service Medicare patients 66 years old or greater.

Main Measures

Length of stay (LOS), professional services (Part B) inpatient spending, specialty consultation, discharge to home, all-cause 7- and 30-day readmissions, and 30-day mortality.

Key Results

A total of 294,150 patients with hip fracture were admitted to 2466 hospitals. Patients cared for in low-use (Q1) versus high-use (Q4) hospitals did not differ meaningfully in demographic characteristics or comorbidities. Hospitals ranged in use of the hospitalist care model from 12% in low-use (Q1) hospitals to 81% in high-use (Q4) hospitals. Low-use hospitals had significantly higher inpatient consult use (unadjusted: Q1 vs Q4, 1.06 vs 0.63 consults, p < 0.0001; adjusted: −0.36, p < 0.001) and length of stay (unadjusted: Q1 vs Q4, 6.04 vs 5.94 days, p < 0.0001; adjusted: −0.09 days, p < 0.05), but no significant difference in adjusted analyses for spending, likelihood of discharge home, 7- and 30-day readmission, or 30-day mortality.

Conclusions

Hospitalist care for older adults admitted for hip fracture surgery is both common and associated with slightly shorter length of stay.