This application from the Mount Sinai School of Medicine proposes a five-year longitudinal study to address the outcomes and management of hip fractures in the Mount Sinai Health System in New York City. The Mount Sinai Health System is an integrated network of 26 hospitals, nursing homes, and home care agencies. Specifically, the study will determine the feasibility and validity of functional status as a measure of quality for patients with hip fractures one, two, and six months after admission. The data collection represents a merger of an earlier RAND Prospective Payment Study (PPS), which used record abstraction and administrative data, and Jay Magaziner's Baltimore Hip Studies, which examined hip fracture outcomes with an emphasis on functional and social measures. This study has three major phases. In the first, the investigators will follow approximately 500 hip fracture patients admitted to four hospitals. Research nurses will collect detailed information during the course of the hospitalization and will follow the cases into the community, collecting information from post-hospital providers and outcomes information from the patients and proxies. In the second Phase, results from Phase I will be shared with the hospitals and staff. The effectiveness of this intervention will be assessed by repeating a scaled down version of Phase I. Phase III involves spreading the approach to ten hospitals in the system. The final product will an operational set of procedures for collecting meaningful functional status data on patients with hip fracture.
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