大腿骨頚部骨折地域連携クリニカルパスの運用効果

Practical Effect of a Liaison-Clinical Pathway for Femoral Neck Fractures

　2006年から2010年の期間に当科で治療した大腿骨頚部骨折患者425例における大腿骨頚部骨折地域連携計画書(以下，連携パス)の使用実績を調査した．連携パスの使用は98例で，使用率は経年的に増加した．当科における入院期間は短縮せず転院症例も増加しなかったが，退院後の患者情報がフィードバックされた．連携病院での入院期間は，30日程度で退院できる患者群と90日程度の入院を要する患者群に分かれた．連携病院からの自宅退院率は91％であったが，長期間入院した患者群では，歩行介助の状態で退院する比率が高かった．

　We investigated the effect of a clinical pathway for healthcare network management of patients with a femoral neck fracture on reducing length of hospital stay.　The subjects were 425 femoral neck fracture patients who were admitted to our hospital between 2006 and 2010, and the clinical pathway was applied to 98 of them.　Although the clinical pathway was applied to more cases every year, the patients' length of stay was not shortened.　Patients at a cooperating hospital were divided into two groups based on their length of stay：a group whose median stay was approximately 30 days and a group whose median stay was approximately 90 days.　A higher proportion of the patients in the “90-day” group required assistance to walk than in the “30-day” group.