Abstract
Hip fracture in older people is one of the major public health issues worldwide including Thailand. Appropriate care for older people with hip fracture includes fast track surgery and perioperative multidisciplinary team care. This study aimed to monitor pilot hospitals involved in ‘Fast Track Surgery for Hip Fracture Program’ to explore patients’ outcomes and factors associated with the clinical outcomes. We discovered that the operation rate for hip fracture in older people in Thailand remains suboptimal. The rate of non-operative surgery remains high around 40 %. Hospitals in pilot project had higher rate of patients received ‘fast track surgery’ compared to hospitals nationwide. Moreover, pilot hospitals had made significant changes to the policy and process of care for this group of patients. However, some recommended processes could not be arranged. With respect to patients’ outcomes, the mortality rates tend to be reducing in pilot hospitals but did not reach statistically significant. This could stem from the finding that several recommended quality indicators could not be arranged. Multivariate linear regression models were carried out to determine factors at hospital level affecting mortality. Having internists involved in postoperative care significantly associated with lower one-year mortality. Having rehabilitation specialists involved in postoperative care is also associated with lower three-month mortality. Covid-19 pandemic did not have negative impact to operation rate and mortality for hip fracture patients in Thailand.
