Rehabilitation of elderly patients in the community following surgery for hip fracture – utilization of personal and health care services

Abstract

Purpose: To assess the change in utilization of personal and health care services following surgery for hip fracture in elderly patients rehabilitated in the community. Methods: A descriptive study of patients hospitalized in the orthopedic surgery ward for traumatic hip fracture. The first interview took place after surgery and included functional and medical data, and details on utilization of personal and health care services in the month prior to surgery. The second interview took place at home three months after discharge from the hospital and documented corresponding data for the last month. Results: The study included 91 elderly patients. The mean number of contacts with health care providers increased from 4.6/month before HF to 6.4/month during rehabilitation; in particular an increase in home visits by primary care nurses and physicians from 0.4 to 1.0 visit/month (p < 0.001). Personal care showed a greater increase from 32.5 to 95.0 weekly hours (p < 0.001). Multivariate analyses showed that the increase in primary care visits was associated with chronic co-morbidity and being single, while the increase in personal care was associated with medium dependence level and an ambulatory rehabilitation setting. Conclusions: During the rehabilitation period in the community there was an increase in non-rehabilitative services-medical and personal. Morbidity and functional data could predict the increase in use at time of discharge from hospital.

Implications for Rehabilitation

• Fracture of hip is a common event in the elderly that necessitates surgical repair.

• Rehabilitation treatment after surgery for hip fracture aimed to return the patients to pre-event functional status and prevent the further development of disability. Rehabilitation treatment can be provided either in the hospital or in the community.

• During rehabilitation period there is an increase in use of primary care and personal services. Part of the increase can be predicted at time of hospitalization.

Keywords::

• Elderly
• hip fracture
• health services

Declaration of interest: The authors report no conflict of interest.