Objective To explore the clinical effect of multidisciplinary team (MDT) in elderly patients with hip fracture under the model of close-type medical alliance. Methods The elderly patients with hip fracture treated in the Department of Orthopedics of Deyang People’s Hospital between January 2015 and December 2020 were included retrospectively. According to different treatment modes, the patients were divided into traditional mode treatment group (traditional group) and MDT mode treatment group (MDT group). The waiting time for operation, hospitalization time after operation, total hospitalization time, total hospitalization cost, and death and loss of follow-up were analyzed. Results A total of 661 patients were enrolled, including 275 in the traditional group and 386 in the MDT group. There was no significant difference between the two groups in terms of gender, age, Charlson comorbidity index, types of fracture or surgical methods (P>0.05). The waiting time for operation [5.50 (3.50, 7.50) vs. 6.00 (4.00, 6.00) d; Z=−3.473, P=0.001], hospitalization time after operation [7.44 (6.27, 8.67) vs. 8.34 (6.72, 13.70) d; Z=−4.996, P<0.001] and total hospitalization time [12.95 (10.46, 16.30) vs. 15.49 (11.77, 19.91) d; Z=−5.718, P<0.001] in the MDT group were shorter than those in the traditional group. The total hospitalization cost of the MDT group was higher than that of the traditional group, but the difference was not statistically significant [39 300 (33 400, 46 400) vs. 38 000 (31 800, 44 000) Yuan; Z=1.524, P=0.128]. There was no significant difference in the lost follow-up rate between the traditional group and the MDT group (9.82% vs. 6.48%; χ2=2.474, P=0.116). Except in-hospital mortality and 30-day postoperative mortality (P>0.05), there was significant difference between the traditional group and the MDT group in 6-month (6.45% vs. 2.77%; χ2=4.875, P=0.027) and 1-year (11.29% vs. 6.37%; χ2=4.636, P=0.031) postoperative mortality. Conclusion Under the model of close-type medical alliance, MDT can reduce the waiting time for operation, hospitalization time after operation, total hospitalization time, as well as 6-month and 1-year postoperative mortality.
As an important component of the healthcare system reform, the regional rehabilitation medical alliance aims to integrate medical resources within the region, promote standardization, specialization, and accessibility of rehabilitation medical services, and achieve efficient collaboration and resource sharing among medical institutions at all levels. This article comprehensively and systematically reviews and analyzes the current situation of the construction of regional rehabilitation medical alliance in China. At the same time, combined with the construction practice of West China Airport Hospital of Sichuan University, it summarizes experience and puts forward suggestions, providing a reference for the development of regional rehabilitation medical alliance.