Mortality Lower for Hip Surgery Patients With Home Care

But most elderly hemiarthroplasty patients discharged home don't receive home care
By Jeff Muise
HealthDay Reporter

MONDAY, Aug. 16 (HealthDay News) -- Most elderly patients who are discharged home after hemiarthroplasty do not receive home care, but those who do are 43 percent less likely to die within three months than those who are sent home without home care, according to research published online Aug. 16 in CMAJ, the journal of the Canadian Medical Association.

Elham Rahme, Ph.D., of McGill University in Montreal, and colleagues analyzed data on 11,326 subjects in the Canadian province of Quebec, aged 65 and older, who were discharged from the hospital during 1997 to 2004 after undergoing hemiarthroplasty. The researchers studied the association of mortality within three months with post-discharge destination (home with care, home without care, rehabilitation center, nursing home, or hospital).

After discharge, 5.6 percent of patients went home with home care, 29.9 percent went home without home care, 2.0 percent went to a rehabilitation center, 24.2 percent went to a nursing home, and 38.3 percent went to another hospital. Fewer than 16 percent of patients who were discharged home received home care. Though patients discharged with home care were more likely to have atrial fibrillation or acute renal failure, to have been in hospital more than seven days, or to have been admitted to a teaching hospital, the researchers found that they had a lower risk of death compared to those discharged home without care (hazard ratio, 0.57). Among patients who were discharged home, those who had been admitted to a high-volume hospital, had an emergent admission, had osteoarthritis, or were older were less likely to receive home care.

"Our study revealed that home care for patients discharged after hemiarthroplasty may be suboptimal in the province of Quebec. Most patients discharged home did not receive home care in the first three months after discharge, potentially resulting in preventable deaths. This finding has important public health implications and requires further investigation," the authors conclude.

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