{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:39:01Z","timestamp":1790656741739,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T00:00:00Z","timestamp":1641859200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>The orthopedic surgery unit in our suburb serves a large elderly trauma population in addition to providing elective surgeries. As patients with hip fractures have become older and at higher risk of medical complications, our hospital has initiated integrated co\u2010management of these patients by orthopedic surgeons and geriatricians from the point of hospital admission. The aim of this study was to evaluate the impact of the hospital policy change on hip fracture management and clinical outcome indicators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the difference\u2010in\u2010difference approach, in total, 288 consecutive patients with hip fractures treated during the 1\u00a0year before and 2\u2009years after transition to orthogeriatric care from a geriatric consultation model to integrated orthogeriatric care model were compared with 576 patients from other local hospitals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Despite a seasonal trend toward increased length of hospital stay in winter, the intervention significantly reduced the change in mean length of stay (mean difference [95% confidence interval], \u221212.9\u2009days [\u221221.5 to \u22124.3]; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.007) and discharge to home tended to change less frequently (\u221212.6%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.10). There was no significant reduction in mean time to surgery (\u22120.2\u2009days; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.83), mortality (\u22120.8%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.62), or complications (\u22121.0%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.85).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Changing our hip fracture service from a geriatric consultation model of care to an integrated orthogeriatric model significantly reduced length of hospital stay probably due to a lower chance of discharge to home. To our knowledge, this is the first study in Japan to compare two orthogeriatric care models considering the nationwide improvement in hip fracture management. <jats:bold>Geriatr Gerontol Int 2022; 22: 138\u2013144<\/jats:bold>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ggi.14347","type":"journal-article","created":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T07:36:28Z","timestamp":1641972988000},"page":"138-144","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Impact of orthogeriatric care management by orthopedic surgeons and physicians on in\u2010hospital clinical outcomes: A difference\u2010in\u2010difference analysis"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6224-5519","authenticated-orcid":false,"given":"Takahisa","family":"Ogawa","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery Suwa Central Hospital  Nagano Japan"},{"name":"Department of Epidemiology Harvard T.H.Chan School of Public Health  Boston Massachusetts USA"},{"name":"Department of Orthopaedic and Spine Surgery Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haggai","family":"Schermann","sequence":"additional","affiliation":[{"name":"Division of Orthopedic Surgery Tel Aviv Sourasky Medical Center, Affiliated with Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aayush","family":"Khadka","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population Harvard University, Dental University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janelle","family":"Moross","sequence":"additional","affiliation":[{"name":"Office for Global Education and Career Development Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mutsuko","family":"Moriwaki","sequence":"additional","affiliation":[{"name":"Department of Tokyo Metropolitan Health Policy Advisement, Graduate School of Medicine Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1894-0290","authenticated-orcid":false,"given":"Kiyohide","family":"Fushimi","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Informatics Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeo","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Department of Global Health Promotion Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3511-9020","authenticated-orcid":false,"given":"Toshitaka","family":"Yoshii","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Spine Surgery Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Okawa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Spine Surgery Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichi","family":"Shirasawa","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Suwa Central Hospital  Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-018-3928-5"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2018.04.014"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e3182a5a045"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-016-2543-4"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638280500056030"},{"key":"e_1_2_7_7_1","unstructured":"Overview|Hip Fracture:Management|Guidance|NICE. 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