title: Home care after hip fracture in a health planning region.
abstract: Health-care restructuring has increased the focus on integrating health care. Therefore the study purpose was to quantify patient movement from hospital to home care before restructuring occurred in a health planning district. Hospital discharge abstracts and home care records identified patients with a hip fracture who used home care (n = 353). Patients from acute care were more likely than rehabilitation or convalescent inpatients to wait > 3 days for home care after hospital discharge (RR 1.54, 95% CI 1.18, 2.00). Institution-dwellers were more likely than community-dwellers to wait > 3 days for home care (RR 2.35, 95% CI 1.86, 2.97). Home care rehabilitation clients were more likely than non-rehabilitation users to wait > 3 days for home care (RR 2.10, 95% CI 1.42, 3.09). Waiting time for home care is associated with hospital care setting and the home care service utilized. Evaluations of restructuring efforts should consider accounting for these relationships.
authors.affiliation: Ontario Joint Replacement Registry, London Health Sciences Centre-University Campus, 339 Windermere Road, P.O. Box 5339, London, ON, N6A 5A5. bert.chesworth@lhsc.on.ca
authors.forename: B M
authors.initials: BM
authors.lastname: Chesworth
authors.forename: M
authors.initials: M
authors.lastname: Speechley
authors.forename: K
authors.initials: K
authors.lastname: Hartford
authors.forename: R
authors.initials: R
authors.lastname: Crilly
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D006302:Health Services Research; D006620:Hip Fractures / Q000534:rehabilitation*; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008297:Male; D009864:Ontario; D010351:Patient Discharge; D026761:Physical Therapy Specialty; D012040:Regional Health Planning / Q000379:methods*; D012306:Risk; D018709:Statistics, Nonparametric