Changing patterns of hip fracture care before and after implementation of the prospective payment system
J. F. Fitzgerald, L. F. Fagan, W. M. Tierney and R. S. Dittus
We tested the hypothesis that since the implementation of the prospective
payment system (PPS), elderly patients hospitalized for hip fractures
receive shorter, less care-intensive hospitalizations and are more
frequently institutionalized. In blinded fashion, we reviewed the charts of
elderly patients with hip fractures admitted to a municipal hospital from
1981 through 1985. Demographic and clinical characteristics of patients
treated before implementation of the PPS were similar to patients treated
thereafter. After implementation of the PPS, the mean length of
hospitalization fell from 16.6 to 10.3 days, and the mean number of
physical therapy sessions received decreased from 9.7 to 4.9.
Concomitantly, the proportion of patients discharged to a nursing home
increased (21% to 48%), as did the proportion receiving nursing home care
at six months after discharge (13% to 39%). This increase in long-term
nursing home placement suggests that the quality of care for elderly
patients with hip fractures may have deteriorated.
Outcome after surgery for fracture of the hip in patients aged over 95 years
Holt et al.
J Bone Joint Surg Br 2006;88-B:1060-1064.
ABSTRACT
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Cross-Sectional and Longitudinal Risk Factors for Falls, Fear of Falling, and Falls Efficacy in a Cohort of Middle-Aged African Americans
Andresen et al.
Gerontologist 2006;46:249-257.
ABSTRACT
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Comparison of early postoperative functional levels following total hip replacement using minimally invasive versus standard incisions. A prospective randomized blinded trial
Lawlor et al.
Clin Rehabil 2005;19:465-474.
ABSTRACT
Interdisciplinary inpatient care for elderly people with hip fracture: a randomized controlled trial
Naglie et al.
CMAJ 2002;167:25-32.
ABSTRACT
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Pediatric Milliman and Robertson Length-of-Stay Criteria: Are They Realistic?
Sills et al.
Pediatrics 2000;105:733-737.
ABSTRACT
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Effect of Acute Inpatient Rehabilitation on Outcome after Fracture of the Femoral Neck or Intertrochanteric Fracture
KOVAL et al.
JBJS 1998;80:357-64.
ABSTRACT
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Secular Trends in Hip Fracture Occurrence and Survival: Age and Sex Differences
Bacon
J Aging Health 1996;8:538-553.
ABSTRACT
Hip Fracture
Zuckerman
NEJM 1996;334:1519-1525.
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Community Residence One Year After Hip Fracture
Furstenberg and Mezey
Journal of Applied Gerontology 1988;7:193-204.
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