Open AccessComparison of Highly Intensive Home-Based Post-acute Care to Inpatient Program for Patients With Fragility Fractures After Surgery
Author(s) -
Min-Chang Lee,
Lin-Chung Woung,
Jau-Yih Tsauo,
Shih-Liang Shih,
Hung-Ming Chen,
Dachen Chu,
ShengJean Huang
Publication year - 2022
Publication title -
geriatric orthopaedic surgery and rehabilitation
Language(s) - English
Resource type - Journals
eISSN - 2151-4593
pISSN - 2151-4585
DOI - 10.1177/21514593221081376
Subject(s) - medicine , fragility , confidence interval , activities of daily living , retrospective cohort study , barthel index , physical therapy , chemistry
Evidence suggests that patients with fragility fractures would benefit from post-acute care (PAC); however, they have been subjected to varying PAC programs. This study aimed to compare the effectiveness of home-based PAC (HPAC) to inpatient PAC (IPAC) programs for patients with fragility fractures in Taiwan.Materials and methods This is a retrospective study that reviewed the medical records of patients who received HPAC or IPAC within three weeks after hip, knee, or spine fragility fractures in the Taipei City Hospital from September 1, 2017, to August 31, 2018.Results The mean age (78.9 ± 10.8 years) showed significant difference between the HPAC (age = 80.6 ± 11.1, n = 83) and the IPAC (age = 78.2 ± 10.6, n = 185) groups ( P = .049). After PAC, both HPAC and IPAC groups showed improvement on Barthel index, numerical pain rating scale, and Harris hip score (all P < .001). Patients in the HPAC group displayed greater improvement than the IPAC group on Barthel Index for activities of daily living (ADLs) by 5.8 (95% confidence interval, 3.0 to 8.5). The IPAC group had a significant longer length of PAC than the HPAC group (12.4 ± 3.0 vs. 11.1 ± 2.7, P < .001).Conclusion Both PAC programs could significantly improve functional performance and reduce pain in patients with fragility fractures. Patients treated in the HPAC group had better ADLs, and less length of PAC.