Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Care Model for Hip-fractured Elderly Persons With Diabetes Mellitus
Brief Summary: The purpose of this study is to 1) develop a well-conceived and feasible protocol for hospital discharge and subacute care for hip-fractured elderly persons with DM, and 2) compare the costs and effectiveness of this DM-specific model with those of an effective subacute care model previously developed by our research team.


Options:
A: Inclusion Criteria:

* Inclusion criteria on cluster level are:

  1. Written agreement to participate in the study;
  2. Agreement that a care pathway for PFF will not be developed and used within the time frame of the study when randomized in the control group.
* Inclusion criteria on patient level are:

  1. Written informed consent;
  2. All consecutive admissions with PFF;
  3. Minimum age of 65 years;
  4. Closed fracture;
  5. Eligible for surgical intervention;
  6. ASA-score of 1, 2 or 3;
  7. Each patient was included only once in the study at initial hospitalization, even if the patient has been hospitalized more than once.

Exclusion Criteria:

* Exclusion criteria on patient level:

  1. Patients with severe dementia (DSM IV);
  2. Bone metastatic diseases (pathologic fractures);
  3. Second fracture on the same hip (i.e. peri-prosthetic fracture)

Inclusion criteria on multidisciplinary team level:

1. Team members are involved in direct patient care responsibilities for PFF;
2. Minimum representation of the core disciplines according to PFF literature;
B: Inclusion Criteria:

* Admitted to Barnes Extended Care nursing home
* Acute disablement
* (criterion dropped) Clinically depressive symptoms, including a score of 15 or greater on the Hamilton Depression Rating Scale (HAM-D) and depressed mood or anhedonia present more days than not since the fracture

Exclusion Criteria:

* Unable to provide informed consent due to dementia and severe persistent delirium
* Inability to cooperate with the protocol
* Cardiac or other medical instability that would preclude carrying out high intensity exercises
* Language, visual, or hearing barriers to participation
* Presence of pelvic fractures that do not involve the proximal femur
* Presence of metastatic cancer, including cancer that causes a pathological fracture
* Bilateral acute hip fractures
* Lifetime psychosis or mania
* Alcohol or substance dependence within 6 months, or current (prior to hip fracture) alcohol or substance abuse
C: Inclusion Criteria:

1. Age 60 years or older (this criterion is based on our previous NHRI-funded study: Intervention program for elderly patients with hip fracture, 2001-2003),
2. Diagnosed with DM,
3. Admitted to CGMH from its emergency room due to hip fracture, and
4. Living in northern Taiwan (i.e.,greater Taipei area, Keelung, Taoyuan, or Shin-Ju Province).

Exclusion Criteria:

1. Clinical diagnosis of Cancer
2. Can't communicate with researchers
D: Inclusion Criteria:

* Patients who are 65 years of age and older, and who have been admitted for a hip fracture to the Fracture Service at New York Presbyterian Hospital.

Exclusion Criteria:

* Patients who are unable to give informed consent on the 4th or 5th day after surgery.
* Patients whose hip fracture is due to underlying disease, secondary to malignancy (cancer).
* Patients who do not speak English.
* Patients for whom exercise is contraindicated or whose physicians believe that exercise is contraindicated.
* Patients who do not have access to a telephone or cannot be reached by telephone.
* Patients and physicians who refuse to participate or who intend to relocate upon discharge.

Answer: C