@article{ref1,
title="Development of a value-based algorithm for inpatient triage of elderly hip fracture patients",
journal="Journal of the American Academy of Orthopaedic Surgeons",
year="2019",
author="Konda, Sanjit R. and Lott, Ariana and Egol, Kenneth A.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="INTRODUCTION: The purpose of this study was to combine a validated middle-age and geriatric trauma risk assessment tool (STTGMA) with a novel cost-prediction tool to create an objective triage tool for elderly hip fractures that would guide value-based care initiatives. <br><br>METHODS: From October 2014 to January 2018, all patients aged ≥55 years who were admitted with a primary diagnosis of hip fracture to a single level 1 trauma center were enrolled. Upon evaluation in the emergency department, demographics, injury severity, and functional status were recorded to calculate the trauma triage score (STTGMARisk). A model to predict high-cost hip fracture patients was created using similar variables (STTGMACost). <br><br>RESULTS: Three hundred sixty-one consecutive operative hip fracture patients were enrolled. Inpatient mortalities were skewed toward STTGMARisk3 with 21.4% of patients in this high-risk group ultimately expiring during their hospitalization. High-cost patients were correctly skewed to the STTGMACost2 and STTGMACost3 groups with 88.9% of all high-cost operatively treated hip fracture correctly triaged to these cohorts. Statistically significant variations were found in cost within each STTGMARisk group. <br><br>CONCLUSIONS: A simple risk score calculated upon admission (STTGMARisk and STTGMACost) was able to be used as a triage tool not only to differentiate increased mortality risk but also to predict high-cost patients based on resource utilization in hip fracture patients. LEVEL OF EVIDENCE: Prognostic, level II.<p /> <p>Language: en</p>",
language="en",
issn="1067-151X",
doi="10.5435/JAAOS-D-18-00400",
url="http://dx.doi.org/10.5435/JAAOS-D-18-00400"
}