Institutionalized patients with hip fractures: characteristics associated with returning to community dwelling.
The authors sought to identify patient- and nursing home-specific characteristics associated with a return to community living among patients with hip fractures discharged initially to nursing homes. One hundred eighty-nine free-living elderly patients were admitted for hip fractures to a 1,120-bed community hospital during 1984-1986. At hospital discharge, 114 (60%) of these patients were institutionalized. One year later, 49/114 (43%) had returned to the community. Three factors independently correlated with patients' return to community living: being discharged to a nursing home with a large ratio of annual admissions to number of beds (RR = 2.51, 95% CI 1.65, 3.94), achieving any in-hospital ambulation (RR = 4.24, 95% CI 1.77, 8.14), and receiving conventional Medicare insurance (RR = 0.37, 95% CI 0.05, 0.53). These data suggest the existence of patient and nursing home features that identify those institutionalized patients with hip fractures who are more likely to return to community dwelling.
Regenstrief Institute for Health Care, Indianapolis, IN 46202.
J F
JF
Fitzgerald
R S
RS
Dittus
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001509:Bed Occupancy; D002204:Capitation Fee; D004434:Early Ambulation; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006279:Health Maintenance Organizations / Q000191:economics; D006620:Hip Fractures / Q000534:rehabilitation*; D006707:Homes for the Aged; D006801:Humans; D007196:Indiana; D007349:Insurance, Health, Reimbursement / Q000191:economics; D008297:Male; D006278:Medicare / Q000191:economics; D009735:Nursing Homes; D010043:Outcome and Process Assessment, Health Care; D010351:Patient Discharge; D012044:Regression Analysis; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States