TY - JOUR
T1 - Survival benefits of post-acute care for older patients with hip fractures in Taiwan
T2 - A 5-year prospective cohort study
AU - Peng, Li Ning
AU - Chen, Wei Ming
AU - Chen, Cheng Fong
AU - Huang, Ching Kuei
AU - Lee, Wei Ju
AU - Chen, Liang Kung
N1 - Publisher Copyright:
© 2016 Japan Geriatrics Society.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Aim: To evaluate the survival benefits of different models of post-acute care (PAC) services for older patients with hip fractures in Taiwan Methods: This was a prospective cohort study that recruited elderly patients with hip fractures receiving surgical treatment from 2007 to 2009 for study. All patients were provided home-based PAC, institution-based PAC or conventional home care (CHC) based on their capacity of family care resources. Functional status and survival status was followed for 4 years. Results: Overall, 453 hip fracture patients (mean age 81.9±6.8 years, 58.8% men) were recruited for the present study. Among them, 29.4% (133/453) patients received home-based PAC, 25.6% (116/453) patients received institution-based PAC and 45.0% (204/453) received CHC. During follow up, 28.9% (131/453) died within the mean of 940.3±453.40 days. Adjusted for age, sex, living status, visual acuity, mood status, previous fall history, and prefracture activities of daily living (ADL) and instrumental activities of daily living (IADL), ADL fully recovered patients were significantly more likely to survive in the 4-year follow up (HR 2.791, P=0.01, 95% CI 1.261-6.149). Patients receiving either home- or institution-based PAC had better survival than the CHC group after adjustment for age, sex, living status, visual acuity, mood status, previous fall history, prefracture ADL and IADL (HR 0.486, P=0.008, 95% CI 0.284-0.832 for home-based PAC; HR 0.546, P=0.036, 95% CI 0.311-0.960 for institution-based PAC). Conclusions: PAC services were of great survival benefit for elderly hip fracture patients, and the home-based model was more likely to achieve complete functional recovery, which was important for long-term survival. Geriatr Gerontol Int 2016; 16: 28-36.
AB - Aim: To evaluate the survival benefits of different models of post-acute care (PAC) services for older patients with hip fractures in Taiwan Methods: This was a prospective cohort study that recruited elderly patients with hip fractures receiving surgical treatment from 2007 to 2009 for study. All patients were provided home-based PAC, institution-based PAC or conventional home care (CHC) based on their capacity of family care resources. Functional status and survival status was followed for 4 years. Results: Overall, 453 hip fracture patients (mean age 81.9±6.8 years, 58.8% men) were recruited for the present study. Among them, 29.4% (133/453) patients received home-based PAC, 25.6% (116/453) patients received institution-based PAC and 45.0% (204/453) received CHC. During follow up, 28.9% (131/453) died within the mean of 940.3±453.40 days. Adjusted for age, sex, living status, visual acuity, mood status, previous fall history, and prefracture activities of daily living (ADL) and instrumental activities of daily living (IADL), ADL fully recovered patients were significantly more likely to survive in the 4-year follow up (HR 2.791, P=0.01, 95% CI 1.261-6.149). Patients receiving either home- or institution-based PAC had better survival than the CHC group after adjustment for age, sex, living status, visual acuity, mood status, previous fall history, prefracture ADL and IADL (HR 0.486, P=0.008, 95% CI 0.284-0.832 for home-based PAC; HR 0.546, P=0.036, 95% CI 0.311-0.960 for institution-based PAC). Conclusions: PAC services were of great survival benefit for elderly hip fracture patients, and the home-based model was more likely to achieve complete functional recovery, which was important for long-term survival. Geriatr Gerontol Int 2016; 16: 28-36.
KW - Hip fracture
KW - Home care
KW - Institute care
KW - Osteoporosis
KW - Post-acute care
UR - http://www.scopus.com/inward/record.url?scp=84953635458&partnerID=8YFLogxK
U2 - 10.1111/ggi.12429
DO - 10.1111/ggi.12429
M3 - Article
C2 - 25598356
AN - SCOPUS:84953635458
SN - 1444-1586
VL - 16
SP - 28
EP - 36
JO - Geriatrics and Gerontology International
JF - Geriatrics and Gerontology International
IS - 1
ER -