Examining trajectories of hospital readmission in older adults hospitalised with hip fracture from residential aged care and the community.
Hip fracture
Hospital readmission
Hospitalisation
Injury
Residential aged care
Journal
Archives of osteoporosis
ISSN: 1862-3514
Titre abrégé: Arch Osteoporos
Pays: England
ID NLM: 101318988
Informations de publication
Date de publication:
17 08 2021
17 08 2021
Historique:
received:
08
12
2020
accepted:
06
05
2021
entrez:
18
8
2021
pubmed:
19
8
2021
medline:
29
10
2021
Statut:
epublish
Résumé
Hip fracture trajectories have not been examined for older adults in aged care or living in the community. Trajectories of health care use were defined by distinct predictive factors. These results can inform the development of targeted strategies to reduce health service use following hip fracture. To examine hospital service use trajectories of older adults who were hospitalised for hip fracture and living in a residential aged care facility (RACF) or the community, and to identify factors predictive of trajectory group membership. These findings may inform future programmes aimed at reducing unexpected hospitalisations and subsequently reduce health care costs. A group-based trajectory analysis of hospitalisations was conducted for adults aged ≥ 65 years hospitalised for hip fracture during 2008-2009 in New South Wales, Australia. Linked hospitalisation and RACF data were examined for a 5-year period. Group-based trajectory models were derived for RACF and community-dwelling older adults based on the number of subsequent hospital admissions following the index hip fracture. Multinomial logistic regression examined predictors of trajectory group membership for subsequent hospital admissions. There were 5752 hip fracture hospitalisations, with two-thirds of hip fractures occurring in community-dwellers. Key predictors of trajectory group membership for both RACF residents and community-dwellers were age group, sex, hospital length of stay and cognitive impairment. Assistance with activities of daily living and complex health care needs were also predictive of group membership in RACF residents. Location of residence and time to move to a RACF were additional predictors of group membership for community-dwellers. Health service use trajectories differed for RACF residents and community-dwellers; however, there were similar patient characteristics that defined trajectory group membership. Low users of hospital services living in RACFs or the community included older adults with generally unfavourable health conditions, potentially indicating that palliative care or advanced care directives and community-care initiatives, respectively, have played a part in the lowered frequency of rehospitalisation.
Identifiants
pubmed: 34405278
doi: 10.1007/s11657-021-00966-x
pii: 10.1007/s11657-021-00966-x
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
120Informations de copyright
© 2021. International Osteoporosis Foundation and National Osteoporosis Foundation.
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