Intensive rehabilitation in selected hip fracture patients may optimize care efficiency: A retrospective comparison study
Joep B. Ponten, Egbert Krug, Laurens J. van Baardewijk , Enrike (H)MJ van der Linden, Renée Haas , Pieta Krijnen, Inger B. Schipper
Surgery-Traumatology, Leiden University Medical Center, NL-2300 RC Leiden, The Netherlands
Objective: To gather preliminary data on the effectiveness of intensive rehabilitation after hip fracture surgery, as provided in the Transfer Unit (TU) in Leiden, The Netherlands, compared with the effectiveness of rehabilitation in a regular nursing home. Intensive rehabilitation in the TU consists of physical therapy twice daily by dedicated medical staff and aims to shorten hospital stay and duration of rehabilitation, in order to increase the hospital admission capacity and reduce waiting lists for nursing homes.
Design: Retrospective cohort study.
Patients: A total of 173 hip fracture patients, selected postoperatively for intensive rehabilitation in the TU. Of these, 156 received TU rehabilitation (TU+ group), while 17 were rehabilitated in regular nursing homes for logistic reasons (TU– group).
Methods: Length of hospital stay, rehabilitation duration and survival were compared between TU+ and TU–.
Results: Both groups appeared comparable at baseline. TU+ patients had a mean hospital stay of 10.4 vs 12.3 days for TU– patients (p = 0.29), while their rehabilitation duration was 25.2 days shorter: 42.0 vs 67.2 days (p = 0.001). One-year survival was similar (87%).
Conclusion: Intensive rehabilitation in selected hip fracture patients may reduce rehabilitation duration by almost 4 weeks. Differentiated aftercare appears to increase care efficiency for hip fracture patients in both hospitals and nursing homes and may result in a significant reduction in costs.
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