The comparison of hip fractures care in Lithuania and Sweden

• Published in: International journal of orthopaedic and trauma nursing Vol. 16; no. 1; pp. 47 - 52
• Main Authors: Valavičienė, Rasa, Macijauskienė, Jūratė, Smailys, Alfredas, Hommel, Ami
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.02.2012
• Subjects: Fractured hips; Hip fracture; Hip fracture care pathways; Length of stay; Lithuania; Pressure sores; Surgery; Sweden; Lithuania; Sweden; Hip fracture; Hip fracture care pathways
• ISSN: 1878-1241; 1878-1292
• DOI: 10.1016/j.ijotn.2011.07.002

The aim of this study was to audit hip fracture patients’ care in Lithuania and compare it to Sweden’s, identifying the differences in Lithuania, changes required for further care improvement, for a country where no integrated care pathways had been introduced. We investigated 64 hip fracture patients treated in Lithuania and 90 hip fracture patients treated in Sweden for a period of one year according our “fast track” protocol. Information about medical interventions, mean time period from admission to surgery, length of stay in the orthopedic department, incidence of pressure ulcers and information about discharge location was collected and compared in both institutions. No oxygen therapy, infusion therapy, blood sampling and ECG were conducted in Lithuania during patients’ transportation to the institution, but that was not the case in Sweden. Contrary to Lithuania, patients at Lund University Hospital do not attend the Acute & Emergency room and Swedish patients are supposed to be operated on within 24 h. Time to surgery in Lithuania was more than twice as long, but a rather similar in-hospital stay was observed. However, most patients in Lithuania are discharged to a rehabilitation clinic for 18 days. Audit results of hip fracture care in Lithuania compared to Sweden showed potentially some benefits using the hip fracture care pathway, which was particularly associated with shorter time to surgery, thus reducing the risk of complications in this vulnerable group of old patients. Making comparisons like this in other countries may be useful, but must be taken in context along with the local culture and health care system.