Article

Veterans hospitalized for hip fracture repair may be discharged to one of several
rehabilitation settings, but it is not known what factors influence postsurgical
discharge setting. The purpose of the study was to examine the patient, facility,
and market factors that influence the choice of postsurgical discharge setting.
Using a retrospective cohort design, we linked 11,083 veterans who had hip
fracture surgeries in a Department of Veterans Affairs (VA) hospital from 1998 to
2005 as assessed by the VA National Surgical Quality Improvement Program dataset
with administrative data. The factors associated with five postdischarge settings
were analyzed using multinomial logistic regression. We found that few veterans
(0.8%) hospitalized for hip fracture were discharged with home health. Higher
proportions of veterans were discharged to a nursing home (15.4%), to outpatient
rehabilitation (18.8%), to inpatient rehabilitation (16.9%), or to home (48.2%).
Patients were more likely to be discharged to nonhome settings for VA-provided
rehabilitation if they had total function dependence, had American Society of
Anesthesiologists class 4 or 5, had surgical complications prior to discharge, or
lived in counties with lower nursing home bed occupancy rates. Future research
should compare postsurgical and longer-term morbidity, mortality, and healthcare
utilization across these rehabilitation settings.

Langue : ANGLAIS