Posthospital setting, resource utilization, and self-care outcome in older women with hip fracture.

OBJECTIVE

To compare posthospital rehabilitation resource utilization and self-care outcome of women with hip fracture discharged to three types of setting (home, inpatient rehabilitation, skilled nursing).

DESIGN

Prospective cohort study. Patient interviews in the hospital, 2 and 6 months after fracture, hospital record reviews.

SETTING

Two general community and two teaching hospitals.

PATIENTS

Consecutive sample of community-living women with hip fracture, aged 65 and over. Of 179 eligible, 130 patients enrolled and 123 completed study.

INTERVENTIONS

Prospective observational study.

MAIN OUTCOME MEASURES

Posthospital institutional days, cumulative sessions of physical and occupational therapy within 6 months after fracture, and 2- and 6-month Barthel Index.

RESULTS

For patients discharged to home, inpatient rehabilitation, and skilled nursing, respectively, mean posthospital institutional days were 1, 16, and 50; mean sessions of physical therapy were 15, 35, and 50; mean sessions of occupational therapy were 0, 11, and 16; mean 2-month Barthel Index was 93, 89, and 80; mean 6-month Barthel Index was 89, 88, and 86. Differences in posthospital institutional days and physical and occupational therapy sessions, but not 2- and 6-month Barthel Index, were statistically significant after controlling for patient characteristics.

CONCLUSIONS

Type of posthospital setting is associated with resource utilization, but not self-care outcome after hip fracture.