Introduction: Of significant interest is where the elderly patient goes after hospital discharge. This study investigates factors associated with the chance that an individual will be discharged to a nursing home following hip fracture. Methods: Computerized hospital discharge data for New York State were obtained for admissions between January 1985 and December 1996. Patients had to be at least 65 years old and home dwelling. Our outcome was whether the individual was discharged home or to a nursing home. Predictor variables included: type of surgery (replacement vs. fixation), type of fracture, comorbidities, age, gender, and year of admission. Logistic regression was used to estimate the odds ratios for assessing the relationships between predictor and outcome variables. Results: 107,893 cases met the criteria. In 36% of the cases the patient was discharged to a nursing home. Univariate analysis showed that the following factors were associated with discharge to nursing home: 1) IT fracture (OR=1.4, p<0.01); 2) individuals with 3 or more comorbidities (OR=1.91, p<. 01); 3) age greater than 85 years (OR=2.48, p<. 01); 4) year of admission (OR=1.92, p<. 01). Discharge to a skilled nursing facility is much more common nowadays than in 1985 (20% in 1985, 53% in 1996). Year of admission remained highly predictive after adjusting for fracture type, age, and morbidities (OR=1.9, p<. 01). Conclusions: the proportion of patients discharged to nursing home increases independent of other factors. Reduced time spent in acute-care hospitals, among other factors, may be responsible for this trend.
Learning Objectives: N/A
Keywords: Hip Fractures, Nursing Homes
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.