Bundled Payments for Hip Fracture Surgery Are Associated With Improved Access, Quality, and Health Care Utilization, but Higher Costs for Complex Cases: An Interrupted Time Series Analysis.

Objectives: To study the impact of bundled payments for surgically managed hip fractures on care access, care quality, health care resource utilization, clinical impact, and acute care cost.

Design: An observational retrospective cohort study using a quasi-experimental design comparing prebundled and postbundled payments through an interrupted time series analysis.

Setting: A public acute care general hospital.

Integrated hip fracture care pathway (IHFCP): reducing complications and improving outcomes.

Introduction: Hip fractures in elderly people are increasing. A five-year Integrated Hip Fracture Care Pathway (IHFCP) was implemented at our hospital for seamlessly integrating care for these patients from admission to post discharge. We aimed to evaluate how IHFCP improved process and outcome measures in these patients.

Beyond comanaged inpatient care to community integration: Factors leading to surgical delay in hip fractures and their associated outcomes.

Purpose: Early surgery for older adults with hip fracture has been shown to improve outcomes. We aim to study the factors contributing to delay in surgery (defined as surgery performed more than 48 h after admission) and its associated outcomes in a tertiary hospital in Singapore with an integrated hip fracture program.

Methods: This is a prospective cohort study of hip fracture patients aged more than 60 years over 1 year.

Which frailty measure is a good predictor of early post-operative complications in elderly hip fracture patients?

Introduction: Current pre-operative assessment using, e.g., American Society of Anaesthesiologists score does not accurately predict post-operative outcomes following hip fracture.

Functional improvement of self-care in the elderly after hip fracture: is age a factor?

Introduction: The aging population is growing rapidly in Asia resulting in an increased number of hip fractures being managed surgically. Though there is evidence of improved quality of patient care and outcomes with well-established models of care, we do not know if the functional recovery in activities of daily living among this group of patients is also dependant on age. We hypothesize that there will be a difference in Modified Barthel Index (MBI) scores between the 'older old' (>85 years) and the 'younger old' (<85 years).

Orthogeriatric model for hip fracture patients in Singapore: our early experience and initial outcomes.

Introduction: The aging population is growing rapidly in Asia resulting in an increased number of fragility fractures. Studies have shown that an integrated model of care for the elderly can improve the quality of patient care and outcomes. This report describes our concept, initial experience and short-term outcomes of the integrated model of care that was established in managing geriatric hip fractures in Tan Tock Seng Hospital, Singapore.