麻酔科医が制度設計した大腿骨近位部骨折患者への包括的集学的治療プログラム

Comprehensive Multidisciplinary Anesthesiologist-designed Management of Patients with a Hip Fracture

要旨

　perioperative surgical home（PSH）は患者中心の集学的なチーム医療モデルである。当院ではPSHを参考に，麻酔科医が大腿骨近位部骨折患者の入院から退院までの包括的集学的治療プログラムの制度設計に参画し，入院日数を短縮し，術後合併症の発症や死亡を減少させ，治療コストの改善と入院期間を短縮するのに貢献している。われわれの専門性を生かすなら，入院から退院までの包括的集学的治療プログラムは麻酔科医が担う今後の周術期医療の一つである。

　Most healthcare systems around the world have been forced to find innovative ways to improve patient outcomes and satisfaction while reducing the costs of healthcare. The perioperative surgical home（PSH）concept is the foundation of a patient-centered, multidisciplinary team-based model of healthcare that streamlines and coordinates patients’ care from the moment the decision is made to perform surgery until the post-hospital discharge phase. The PSH model is designed to emphasize patient satisfaction, value, and reduced costs. Our hospital’s anesthetists now lead the perioperative care of elderly patients with hip fractures, in accord with the PSH concept. We conduct comprehensive multidisciplinary management with reference to PSH, and this policy has been confirmed to be a safe and effective method of providing value-based care to patients undergoing hip fracture surgery. If anesthesiology is to thrive in the future, healthcare institutions should consider implementing comprehensive multidisciplinary care for their patients.