Comparison of hospitalised trends, treatment cost and health outcomes of fall-related hip fracture for people aged ≥ 65 years living in residential aged care and the community

R. Mitchell, B. Draper, L. Harvey, M. Wadolowski, H. Brodaty, J. Close

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Summary: This study compared hip fracture rates and health outcomes of older people living in residential aged care facilities (RACFs) to the community. The RACF resident age-standardised hospitalisation rate was five times higher than the community rate and declining. RACF residents experience overall worse health outcomes and survival post-hip fracture. Introduction: To compare hospitalisation trends, characteristics and health outcomes following a fall-related hip fracture of older people living in residential aged care facilities (RACFs) to older people living in the community. Methods: A retrospective analysis of fall-related hip fracture hospitalisations of people aged ≥ 65 years during 1 July 2008 and 30 June 2013 in New South Wales (NSW), Australia’s largest populated state. Linked hospitalisation, RACF and Aged Care Assessment Appraisal data collections were examined. Negative binomial regression examined the significance of hospitalisation temporal trends. Results: There were 28,897 hip fracture hospitalisations. One-third were of older people living in RACFs. The hospitalisation rate was 2180 per 100,000 (95%CI: 2097.0–2263.7) for RACF residents and 390 per 100,000 (95%CI 384.8–395.8) for older people living in the community. The hospitalisation rate for RACF residents was estimated to decline by 2.9% annually (95%CI: − 4.3 to − 1.5). Hospital treatment cost for hip fractures was AUD$958.5 million. Compared to older people living in the community, a higher proportion of RACF residents were aged ≥ 90 years (36.1% vs 17.2%), were female (75.3% vs 71.8%), had > 1 Charlson comorbidity (37.6% vs 35.6%) and 58.2% had dementia (vs 14.4%). RACF residents had fewer in-hospital rehabilitation episodes (18.7% vs 60.9%) and a higher proportion of unplanned readmissions (10.6% vs 9.1%) and in-hospital mortality (5.9% vs 3.3%) compared to older people living in the community. Conclusions: RACF residents are a vulnerable cohort of older people who experience worse health outcomes and survival post-hip fracture than older people living in the community. Whether access to individualised hip fracture rehabilitation for RACF residents could improve their health outcomes should be examined.

LanguageEnglish
Pages311-321
Number of pages11
JournalOsteoporosis International
Volume30
Issue number2
Early online date19 Dec 2018
DOIs
Publication statusPublished - Feb 2019

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Hip Fractures
Health Care Costs
Hospitalization
Health
Rehabilitation
South Australia
New South Wales
Hospital Costs
Hospital Mortality
Dementia
Comorbidity

Keywords

  • Community
  • Hip fracture
  • Hospitalisation
  • Residential aged care

Cite this

@article{7f80c9d98b6d49e6a23e98f0cc6eaddd,
title = "Comparison of hospitalised trends, treatment cost and health outcomes of fall-related hip fracture for people aged ≥ 65 years living in residential aged care and the community",
abstract = "Summary: This study compared hip fracture rates and health outcomes of older people living in residential aged care facilities (RACFs) to the community. The RACF resident age-standardised hospitalisation rate was five times higher than the community rate and declining. RACF residents experience overall worse health outcomes and survival post-hip fracture. Introduction: To compare hospitalisation trends, characteristics and health outcomes following a fall-related hip fracture of older people living in residential aged care facilities (RACFs) to older people living in the community. Methods: A retrospective analysis of fall-related hip fracture hospitalisations of people aged ≥ 65 years during 1 July 2008 and 30 June 2013 in New South Wales (NSW), Australia’s largest populated state. Linked hospitalisation, RACF and Aged Care Assessment Appraisal data collections were examined. Negative binomial regression examined the significance of hospitalisation temporal trends. Results: There were 28,897 hip fracture hospitalisations. One-third were of older people living in RACFs. The hospitalisation rate was 2180 per 100,000 (95{\%}CI: 2097.0–2263.7) for RACF residents and 390 per 100,000 (95{\%}CI 384.8–395.8) for older people living in the community. The hospitalisation rate for RACF residents was estimated to decline by 2.9{\%} annually (95{\%}CI: − 4.3 to − 1.5). Hospital treatment cost for hip fractures was AUD$958.5 million. Compared to older people living in the community, a higher proportion of RACF residents were aged ≥ 90 years (36.1{\%} vs 17.2{\%}), were female (75.3{\%} vs 71.8{\%}), had > 1 Charlson comorbidity (37.6{\%} vs 35.6{\%}) and 58.2{\%} had dementia (vs 14.4{\%}). RACF residents had fewer in-hospital rehabilitation episodes (18.7{\%} vs 60.9{\%}) and a higher proportion of unplanned readmissions (10.6{\%} vs 9.1{\%}) and in-hospital mortality (5.9{\%} vs 3.3{\%}) compared to older people living in the community. Conclusions: RACF residents are a vulnerable cohort of older people who experience worse health outcomes and survival post-hip fracture than older people living in the community. Whether access to individualised hip fracture rehabilitation for RACF residents could improve their health outcomes should be examined.",
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author = "R. Mitchell and B. Draper and L. Harvey and M. Wadolowski and H. Brodaty and J. Close",
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Comparison of hospitalised trends, treatment cost and health outcomes of fall-related hip fracture for people aged ≥ 65 years living in residential aged care and the community. / Mitchell, R.; Draper, B.; Harvey, L.; Wadolowski, M.; Brodaty, H.; Close, J.

In: Osteoporosis International, Vol. 30, No. 2, 02.2019, p. 311-321.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Comparison of hospitalised trends, treatment cost and health outcomes of fall-related hip fracture for people aged ≥ 65 years living in residential aged care and the community

AU - Mitchell, R.

AU - Draper, B.

AU - Harvey, L.

AU - Wadolowski, M.

AU - Brodaty, H.

AU - Close, J.

PY - 2019/2

Y1 - 2019/2

N2 - Summary: This study compared hip fracture rates and health outcomes of older people living in residential aged care facilities (RACFs) to the community. The RACF resident age-standardised hospitalisation rate was five times higher than the community rate and declining. RACF residents experience overall worse health outcomes and survival post-hip fracture. Introduction: To compare hospitalisation trends, characteristics and health outcomes following a fall-related hip fracture of older people living in residential aged care facilities (RACFs) to older people living in the community. Methods: A retrospective analysis of fall-related hip fracture hospitalisations of people aged ≥ 65 years during 1 July 2008 and 30 June 2013 in New South Wales (NSW), Australia’s largest populated state. Linked hospitalisation, RACF and Aged Care Assessment Appraisal data collections were examined. Negative binomial regression examined the significance of hospitalisation temporal trends. Results: There were 28,897 hip fracture hospitalisations. One-third were of older people living in RACFs. The hospitalisation rate was 2180 per 100,000 (95%CI: 2097.0–2263.7) for RACF residents and 390 per 100,000 (95%CI 384.8–395.8) for older people living in the community. The hospitalisation rate for RACF residents was estimated to decline by 2.9% annually (95%CI: − 4.3 to − 1.5). Hospital treatment cost for hip fractures was AUD$958.5 million. Compared to older people living in the community, a higher proportion of RACF residents were aged ≥ 90 years (36.1% vs 17.2%), were female (75.3% vs 71.8%), had > 1 Charlson comorbidity (37.6% vs 35.6%) and 58.2% had dementia (vs 14.4%). RACF residents had fewer in-hospital rehabilitation episodes (18.7% vs 60.9%) and a higher proportion of unplanned readmissions (10.6% vs 9.1%) and in-hospital mortality (5.9% vs 3.3%) compared to older people living in the community. Conclusions: RACF residents are a vulnerable cohort of older people who experience worse health outcomes and survival post-hip fracture than older people living in the community. Whether access to individualised hip fracture rehabilitation for RACF residents could improve their health outcomes should be examined.

AB - Summary: This study compared hip fracture rates and health outcomes of older people living in residential aged care facilities (RACFs) to the community. The RACF resident age-standardised hospitalisation rate was five times higher than the community rate and declining. RACF residents experience overall worse health outcomes and survival post-hip fracture. Introduction: To compare hospitalisation trends, characteristics and health outcomes following a fall-related hip fracture of older people living in residential aged care facilities (RACFs) to older people living in the community. Methods: A retrospective analysis of fall-related hip fracture hospitalisations of people aged ≥ 65 years during 1 July 2008 and 30 June 2013 in New South Wales (NSW), Australia’s largest populated state. Linked hospitalisation, RACF and Aged Care Assessment Appraisal data collections were examined. Negative binomial regression examined the significance of hospitalisation temporal trends. Results: There were 28,897 hip fracture hospitalisations. One-third were of older people living in RACFs. The hospitalisation rate was 2180 per 100,000 (95%CI: 2097.0–2263.7) for RACF residents and 390 per 100,000 (95%CI 384.8–395.8) for older people living in the community. The hospitalisation rate for RACF residents was estimated to decline by 2.9% annually (95%CI: − 4.3 to − 1.5). Hospital treatment cost for hip fractures was AUD$958.5 million. Compared to older people living in the community, a higher proportion of RACF residents were aged ≥ 90 years (36.1% vs 17.2%), were female (75.3% vs 71.8%), had > 1 Charlson comorbidity (37.6% vs 35.6%) and 58.2% had dementia (vs 14.4%). RACF residents had fewer in-hospital rehabilitation episodes (18.7% vs 60.9%) and a higher proportion of unplanned readmissions (10.6% vs 9.1%) and in-hospital mortality (5.9% vs 3.3%) compared to older people living in the community. Conclusions: RACF residents are a vulnerable cohort of older people who experience worse health outcomes and survival post-hip fracture than older people living in the community. Whether access to individualised hip fracture rehabilitation for RACF residents could improve their health outcomes should be examined.

KW - Community

KW - Hip fracture

KW - Hospitalisation

KW - Residential aged care

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U2 - 10.1007/s00198-018-4800-6

DO - 10.1007/s00198-018-4800-6

M3 - Article

VL - 30

SP - 311

EP - 321

JO - Osteoporosis International

T2 - Osteoporosis International

JF - Osteoporosis International

SN - 0937-941X

IS - 2

ER -