Australas J Ageing. 2020;00:1–7. wileyonlinelibrary.com/journal/ajag
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1 © 2020 AJA Inc.
Received: 16 November 2019
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Revised: 16 May 2020
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Accepted: 20 May 2020
DOI: 10.1111/ajag.12824
RESEARCH ARTICLE
Patients from residential aged care with hip fractures—Does
discharge destination from acute care affect outcomes?
Lara Anderson
1
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Chris Moran
2,3
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Susan Liew
4,5
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Lara A. Kimmel
1,6
1
Physiotherapy Department, The Alfred,
Melbourne, Victoria, Australia
2
Department of Medicine, Peninsula
Health and Monash University, Melbourne,
Victoria, Australia
3
Alfred Health, Melbourne, Victoria,
Australia
4
Department of Orthopaedic Surgery, The
Alfred, Melbourne, Victoria, Australia
5
Department of Surgery, Monash
University, Melbourne, Victoria, Australia
6
Department of Epidemiology and
Preventive Medicine, Monash University,
Melbourne, Victoria, Australia
Correspondence
Ms. Lara Anderson, CO Physiotherapy
Department, The Alfred Hospital,
Commercial Rd, Prahran 3181, Australia.
Email: lara.anderson@alfred.org.au
Funding information
Alfred Hospital, Grant/Award Number:
Small Project Grant
Abstract
Objective: The aim of this study was to describe the demographics of patients from
residential aged care facilities (RACFs) who underwent fixation of hip fracture and
to compare 12-month functional and mortality outcomes for those returning to their
RACF with those admitted to a subacute facility (SAF) following their acute hospital
stay.
Methods: A retrospective review was undertaken of all patients from a RACF with
high-level care needs admitted to Alfred Hospital, Melbourne, for fixation of hip
fracture in 2014-2015. Data including demographic and hospital event details, length
of stay (LOS), discharge destination and 12-month functional outcomes measured by
the Glasgow Outcome Scale-Extended (GOS-E), were collected. Factors related to
discharge destination and outcomes were analysed.
Results: Ninety patients from a RACF were included in this study, with 68 patients
(76%) returning to their RACF and 22 (24%) admitted to a SAF after acute hospital
stay. Those discharged to a SAF had an average LOS at this facility of 20.79 days
(SD 8.02). The SAF group also had a longer acute LOS (7 days IQR 5-10, compared
to 6 days IQR 4-7.5) but there was no difference between groups at 12 months in
terms of mortality or function, with 50% of all patients deceased at this time point
(n = 40) and the remaining 40 patients (50%) reporting a poor functional outcome.
Conclusions: Mobility status during acute and subacute stay, and 12-month func-
tional and mortality outcomes were similar in both groups irrespective of discharge
destination, with the influence of cognition and concomitant medical issues currently
unknown. Further research is required to evaluate the efficacy of current hip fracture
models of care, the factors that influence clinician discharge planning decision-mak-
ing and to interrogate new models of care that support rehabilitation and complex
medical management in RACFs.
KEYWORDS
femoral neck fractures, health services for older people, nursing homes, patient discharge, physical
therapy speciality