ORIGINAL ARTICLE Changes in quality of life among elderly patients with hip fracture in Taiwan Yea-Ing Lotus Shyu Æ Min-Chi Chen Æ Jersey Liang Jui-fen Rachel Lu Æ Chi-Chuan Wu Æ Juin-Yih Su Received: 10 March 2003 / Accepted: 24 September 2003 / Published online: 7 November 2003 Ó International Osteoporosis Foundation and National Osteoporosis Foundation 2003 Abstract To examine the longitudinal change in health related quality of life (HRQoL) during 1 year following hospital discharge in elderly subjects, 110 hip fractured subjects (age, mean±SD: 79.3±7.4 years) were enrolled in a prospective study. Face-to-face interviews with the patients were conducted, using Short Form 36 (SF-36) at 1, 3, 6, and 12 months after they were discharged from the hospital. The GEE approach was employed to evaluate changes in the variables of interest among dif- ferent time points. Subjects in this study appeared to have lower scores in most dimensions of SF-36, with physical function and role limitation being the lowest due to physical problems (mean±SD=10.97±16.19; 6.32±20.60) during the 1st month after hospital dis- charge, compared to community dwelling subjects (mean±SD=77.5±20.5; 63.8±45.30). Most of the dimensions of SF-36, except general health (6th month versus 3rd month=57.56±21.90 versus 61.75±23.46, P>0.05) improved significantly from the 1st month to the 3rd month (range of means of improved scores from 12.81 to 30.76, P<0.01). After the 3rd month after discharge, physical functions kept improving sig- nificantly until 6 months after hospital discharge (3rd month versus 6th month=25.18±23.66 versus 40.30±25.94, P<0.05). Role limitation due to physical problems reached a plateau between the 3rd and 6th month, and then again improved significantly during the 6th month and the 1st year after hospital discharge (6th month versus 1st year=17.69±31.78 versus 32.22±44.47, P<0.05). The rest of the dimensions of SF-36 remained stable from the 3rd month to 1 year after discharge. These results indicated that different aspects of SF-36 recovered differently for the hip frac- tured patients in Taiwan. Similar studies may be helpful for health-care providers in other countries with Chinese populations to develop specific intervention programs. Keywords Elderly persons Æ Health related quality of life Æ Hip fracture Æ Longitudinal change Introduction Hip fracture is a serious consequence of osteoporosis in the elderly because it leads to excess mortality of 5–20%, and morbidity that results in huge economic costs [1]. The percentage of elderly persons (1,973,000) in Taiwan has increased steadily, from 2.7% in 1966 to 8.8% in 2001 [2]. With an increasing aging population, hip fractures represent a major and growing health care problem in Taiwan. According to Tsai et al. [3], it is estimated that the incidence rate (per 100,000) of hip fracture in Taiwan was 211 for the population aged 65 and over (128 in women; 83 in men) in 1993. Tsai and his colleagues reported that despite the use of advanced treatment, the mortality rate remains significant, and Osteoporos Int (2004) 15: 95–102 DOI 10.1007/s00198-003-1533-x Y.-I.L. Shyu (&) Center for Gerontological Research, School of Nursing, Chang Gung University, 259 Wen-Hua 1st Road, Kwei-Shan, 333 Tao-Yuan, Taiwan, ROC E-mail: yeaing@mail.cgu.edu.tw Tel.: +886-3-2118800 ext. 5275 Fax: +886-3-2118400 M.-C. Chen Department of Public Health, Chang Gung University, 259 Wen-Hua 1st Road, Kwei-Shan, 333 Tao-Yuan, Taiwan, ROC J. Liang Health Management and Policy, School of Public Health, M3234 School of Public Health II, University of Michigan, Ann Arbor, MI 48109-2029, USA J.R. Lu Center for Health Industry Management and Public Policy, Department of Health Care Management, Chang Gung University, 259 Wen-Hu 1st Road, Kwei-Shan, 333 Tao-Yuan, Taiwan, ROC C.-C. Wu Department of Orthopedics, Chang Gung Memorial Hospital, 5 Fu-Hsin Street, Kwei-Shan, Tao-Yuan, Taiwan, ROC J.-Y. Su Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, 5 Fu-Shin Street, Kwei-Shan, Tao-Yuan, Taiwan, ROC