A new study published by Penn Medicine found that for elderly patients in the United States who suffered hip fractures, the care provided in nursing homes, rehabilitation facilities, and at-home care had a three to eight times greater impact on outcomes such as mobility and mortality than the hospital care the patients had received.
The study found that nursing home factors were responsible for three times more variation in the probability of dying at 30 days than hospital factors; seven times more variation in the probability of dying at 180 days; and, eight times more variation in the probability of dying or being newly unable to walk at 180 days.
The researchers analyzed 42,000 older Medicare patients who had suffered a hip fracture and who previously had been a nursing home resident between 2005 and 2009. All of the patients involved in the study were over 80 years old, 92% of the patients were white, and 75% of the patients were women. The researchers found that hospital characteristics such as for-profit status, nurse-to-bed ratio, and mean hospital nurse skill mix were not consistently associated with outcomes but that multiple nursing home characteristics such as performance on selected quality measures, bed count, and chain membership did predict outcomes.
The study found that nursing home patients who were treated at a nursing home with a low occupancy, a nursing home with more than 150 beds versus a nursing home with less than 100 beds, and a nursing home with historically high mortality rates were more likely to die or to have new inability to walk after 30 days.
The study also found that a higher number of nursing homes in a specific market and nursing home ownership by a multi-facility organization were modestly associated with 30-day mortality.
Nursing homes that used more full-time physician extenders such as physician assistants and nurse practitioners, as well as nursing homes located within a hospital, were modestly associated with 180-day mortality.
Research into the association between hip fractures in the elderly and the treatment they receive in predicting outcomes is important inasmuch as individuals 65 and older suffer over 300,000 hip fractures in the United Sates every year, and they suffer 1.6 million hip fractures worldwide every year.
The study’s lead author stated, “These results highlight the major impact that post-acute care has on basic outcomes such a survival and walking ability among this population.”
If you or a family member suffered injuries, or worse, while a resident of a nursing home in the United States due to nursing home neglect, nursing home negligence, nursing home abuse, or due to nursing home under-staffing, you should promptly find a local nursing home claim lawyer in your U.S. state who may investigate your possible nursing home claim for you and file a nursing home claim on your behalf, if appropriate.
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