Hip fracture |
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Authors: | Dr Edward W Campion MD Alan M Jette PT MPH PhD Paul D Cleary PhD Bette Ann Harris MS PT |
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Institution: | (1) Present address: Geriatrics Unit, Massachusetts General Hospital and Spaulding Rehabilitation Hospital, Division on Aging, Harvard Medical School, Boston, Massachusetts;(2) Massachusetts General Hospital, Boston, Massachusetts;(3) Department of Social Medicine and Health Policy, Harvard Medical School, Boston, Massachusetts |
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Abstract: | A prospective study of 79 patients with recent hip fracture revealed prior functional impairments with community mobility
(49%), using a bathtub (40%), walking outdoors (26%), and stair-climbing (18%). Eighty-six per cent of patients (mean age
77.9 years) were admitted from home, with 95% surviving to discharge but only 28% returning directly home following surgical
repair. In-hospital complications included confusion (49%), urinary tract infection (33%), and heart rhythm disturbance (26%).
Mean length of stay was 21.7 days and mean hospital charges were $11,052. The outliers (15%) averaged 60.6 days in length
of stay and $28,190 in charges. Stepwise multivariate regression revealed that lengths of stay varied significantly with prefracture
functional status, presence of intertrochanteric fractures, and in-hospital complications, but not with patient age. Examination
of these findings in relation to prospective reimbursement led to the conclusion that hip fracture patients are particularly
vulnerable in the era of new hospital strategies to avoid high-cost patients and curtail hospital costs.
Presented at the meeting of the Gerontological Society of America, November 1984.
Supported by a grant from The Robert Wood Johnson Foundation. |
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Keywords: | hip fracture prospective reimbursement |
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