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.
Fitzgerald
J F
JF
Regenstrief Institute for Health Care, Indianapolis, IN 46202.
Dittus
R S
RS
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