title: Continuity of care and health decline associated with a hip fracture.
abstract: OBJECTIVE
  Identify determinants of health decline associated with hip fracture with the goal of designing interventions.
  
  
  METHODS
  Prefracture and postfracture information was obtained from participants aged 65-plus years fracturing a hip between July 1996 and August 1997. Health utilization data were linked to the cohort data and to an age-gender matched cohort of nonfracture seniors.
  
  
  RESULTS
  Fracture patients were likely to have been hospitalized and have low continuity of care. Patients making frequent physician visits were at increased risk of both prefracture hospitalization and postfracture health decline. Prefracture hospitalization was less likely for patients with high physical function; patients of high mental status were less likely to experience postfracture health decline.
  
  
  CONCLUSIONS
  Health appears to be in decline prefracture. Patients may benefit from continuous physician care to prevent further health deterioration. Some hip fractures can be prevented by identifying high-risk seniors at an early stage and intervening to prevent falls.
authors.affiliation: University of Alberta, CANADA.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Cree
authors.forename: Qian
authors.initials: Q
authors.lastname: Yang
authors.forename: Anne
authors.initials: A
authors.lastname: Sclater
authors.forename: David
authors.initials: D
authors.lastname: Johnson
authors.forename: K C
authors.initials: KC
authors.lastname: Carriere
mesh_terms: D000368:Aged; D002170:Canada; D015331:Cohort Studies; D003266:Continuity of Patient Care; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006620:Hip Fractures; D006760:Hospitalization; D006801:Humans