ArticleHealth services research2023
Geriatric fracture program centering age-friendly care associated with lower length of stay and lower direct costs.
Article in Health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Age-Friendly Healthcare: An Evolutionary Concept Analysis.Journal of clinical nursing · 2024Pooled it
- Geriatric Models of Surgical Care: A Scoping Review.Journal of advanced nursing · 2026Article
- Article
- Toward Senior-Friendly Hospitals: An Overview of Programs, Their Elements and Effectiveness in Improving Care.Gerontology · 2025Review
- Facilitators and Barriers to Implementing the 4Ms Framework of Age-Friendly Health Systems: A Scoping Review.Nursing reports (Pavia, Italy) · 2024Article
- Rural age-friendly ecosystems for older adults: An international scoping review with recommendations to support age-friendly communities.Health science reports · 2023Article
- Geriatric fracture program centering age-friendly care associated with lower length of stay and lower direct costs.Health services research · 2023Article
- Age-Friendly Research: A Pilot Exploration of Tools to Facilitate Inclusion of Older Adults in Research.Gerontology & geriatric medicineArticle
- 4 Steps to 4Ms: A Navigation Guide for a Hospital-Based Composite Measure of 4Ms Care and the Implications for Outcomes Assessment.Inquiry : a journal of medical care organization, provision and financingArticle
- Outcomes Evidence Must Keep Up with the Implementation of the 4Ms Framework to Ensure Age-Friendly Health System Transformation.Inquiry : a journal of medical care organization, provision and financingArticle
- A Path to Better Care for Older Adults: Optimizing Medicare and Medicaid Payments Through Implementation of the CMS Age Friendly Hospital Measure.Inquiry : a journal of medical care organization, provision and financingArticle
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate outcomes associated with an integrated inpatient and outpatient program aimed at optimizing the care of geriatric fracture patients in a mixed community and academic health system setting. DATA SOURCES AND STUDY
settingThis study took place at a tertiary-care, 886-bed hospital system. The Geriatric Fracture Program (GFP) was designed in 2018 using the 4Ms Framework (What Matters, Medication, Mentation, and Mobility). Patients ≥65 years old with non-spine fractures managed by orthopedic faculty surgeons and participating hospitalist groups were included. A fracture liaison team educated patients regarding bone health and ensured ambulatory geriatrics follow-up. Outpatient geriatric visits focused on mobility, fall risk, bone health imaging, and medications. STUDY
designWe compared GFP-enrolled patients (n = 746) to patients seen by non-GFP-participating physicians (n = 852) and used a generalized estimating equations approach and Poisson models to analyze associations between participation in the GFP program and four inpatient outcomes (time to surgery, length of stay, Vizient length of stay index, and total direct costs). We examined outcomes across all fractures and also stratified them by fracture type (hip vs. non-hip). We descriptively examined post-discharge care outcomes: fall, gait, and balance assessments; bone health imaging; and medications. DATA COLLECTION/EXTRACTION
methodsWe collected data through chart reviews/electronic health record extracts from July 2018 to June 2021. PRINCIPAL
findingsGFP-enrolled patients with all fracture types had a significantly lower length of stay (marginal effect [ME]: -2.12, 95%CI: -2.61, -1.63), length of stay index (ME: -0.33, 95%CI: -0.42, -0.25), and total direct costs (ME: -$5316, 95%CI: -$6806, -$3826); the magnitude of the effects was greater for non-hip fractures. There was no significant difference in time to surgery. Of 746 GFP patients, 170 (23%) had a post-discharge visit with a participating geriatrician ≥6 months.
conclusionsA systematic approach to improving care for older adults with fractures improved length of stay and total direct costs.
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