The added effectiveness of early geriatrician involvement on acute orthopaedic wards to orthogeriatric rehabilitation.

AIMS To evaluate the effect of regular input by a geriatrician to an orthopaedic ward. METHOD A geriatrician saw all patients aged over 65 years admitted to an acute orthopaedic ward-this was compared to an adjacent orthopaedic ward which had consultation only service, and also to both wards in the preceding year. All subjects over the age of 65 years with fractured neck of femur admitted over a 4 month period were enroled. Main outcome measures were length of stay, cost, discharge destination. RESULTS In the year prior to study, patients in both wards had a mean total stay of 28 days. On the intervention ward the mean stay was reduced to 20.7 days, and on the control ward to 27 days. The cost per case on the intervention ward was NZ$9400, and on the control ward was NZ$11 500. Eleven percent went to a higher care level on the intervention ward, compared with 23% on the control ward. CONCLUSION Geriatrician input on a twice weekly basis to all patients over 65 years of age on an orthopaedic ward, saves bed days, reduces costs and produces an improved outcome.