Acute care models for hip fracture treatment vs post-acute rehabilitation services in older adults after hip fracture: A comparative claims data analysis from Germany
Objective: Acute geriatric care (geriatric early rehabilitative treatment) and sub-acute (inpatient) geriat-ric rehabilitation are delivered to geriatric patients in Germany after hip fracture. The aim of this study was to compare patients’ outcomes after hip fracture between 3 German federal states...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2020-02-01
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| Series: | Journal of Rehabilitation Medicine |
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| Online Access: |
https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-2630
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| _version_ | 1798018696822652928 |
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| author | Clemens Becker Kilian Rapp Dietrich Rothenbacher Claudia Schulz Hans-Helmut König Gisela Büchele |
| author_facet | Clemens Becker Kilian Rapp Dietrich Rothenbacher Claudia Schulz Hans-Helmut König Gisela Büchele |
| author_sort | Clemens Becker |
| collection | DOAJ |
| description | Objective: Acute geriatric care (geriatric early rehabilitative treatment) and sub-acute (inpatient) geriat-ric rehabilitation are delivered to geriatric patients in Germany after hip fracture. The aim of this study was to compare patients’ outcomes after hip fracture between 3 German federal states (Hesse, Bavaria, and Baden-Wuerttemberg) that nearly exclusively offered one of the two geriatric care systems.
Design: Retrospective cohort study with patient-related health insurance claims data.
Patients: Analyses were performed with data from 2009–2012 of over 30,000 patients aged ≥80 years with incident hip fracture.
Methods: Primary outcomes: “increase in care dependency”, “nursing home admission”; secondary outcomes: “rehospitalization”, “mortality”. Multivariate regression models were applied.
Results: Compared with Hesse, the state with acute geriatric care, the risks of an “increase in care dependency” were lower in Bavaria (adjusted ratio = 0.84; 95% confidence interval (95% CI) 0.81–0.87) and Baden-Wurttemberg (0.88; 0.85–0.92), the 2 federal states with sub-acute geriatric rehabilitation. A reduction in the risk of nursing home admission was observed in Baden-Wuerttemberg (0.77; 95% CI 0.69–0.87), but not in Bavaria. Rehospitalization rates were lower in Bavaria and Baden-Wuerttemberg compared with Hesse. There was no difference in mortality.
Conclusion: Some, but not all, outcomes were more favourable in the federal states with sub-acute geriatric rehabilitation than in the federal state with acute geriatric care. |
| first_indexed | 2024-04-11T16:27:32Z |
| format | Article |
| id | doaj.art-e78ce52c8ea845cdae8d78dcd9c1fb56 |
| institution | Directory Open Access Journal |
| issn | 1650-1977 1651-2081 |
| language | English |
| last_indexed | 2024-04-11T16:27:32Z |
| publishDate | 2020-02-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Journal of Rehabilitation Medicine |
| spelling | doaj.art-e78ce52c8ea845cdae8d78dcd9c1fb562022-12-22T04:14:07ZengMedical Journals SwedenJournal of Rehabilitation Medicine1650-19771651-20812020-02-01522jrm0002410.2340/16501977-26302603Acute care models for hip fracture treatment vs post-acute rehabilitation services in older adults after hip fracture: A comparative claims data analysis from GermanyClemens Becker0Kilian RappDietrich RothenbacherClaudia SchulzHans-Helmut KönigGisela Büchele Department of Clinical Gerontology, Robert-Bosch-Hospital , , Stuttgart, Germany. clemens.becker@rbk.de. Objective: Acute geriatric care (geriatric early rehabilitative treatment) and sub-acute (inpatient) geriat-ric rehabilitation are delivered to geriatric patients in Germany after hip fracture. The aim of this study was to compare patients’ outcomes after hip fracture between 3 German federal states (Hesse, Bavaria, and Baden-Wuerttemberg) that nearly exclusively offered one of the two geriatric care systems. Design: Retrospective cohort study with patient-related health insurance claims data. Patients: Analyses were performed with data from 2009–2012 of over 30,000 patients aged ≥80 years with incident hip fracture. Methods: Primary outcomes: “increase in care dependency”, “nursing home admission”; secondary outcomes: “rehospitalization”, “mortality”. Multivariate regression models were applied. Results: Compared with Hesse, the state with acute geriatric care, the risks of an “increase in care dependency” were lower in Bavaria (adjusted ratio = 0.84; 95% confidence interval (95% CI) 0.81–0.87) and Baden-Wurttemberg (0.88; 0.85–0.92), the 2 federal states with sub-acute geriatric rehabilitation. A reduction in the risk of nursing home admission was observed in Baden-Wuerttemberg (0.77; 95% CI 0.69–0.87), but not in Bavaria. Rehospitalization rates were lower in Bavaria and Baden-Wuerttemberg compared with Hesse. There was no difference in mortality. Conclusion: Some, but not all, outcomes were more favourable in the federal states with sub-acute geriatric rehabilitation than in the federal state with acute geriatric care. https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-2630 hip fracture health services for the aged disability care dependency nursing home mortality rehabilitation hospitalization. |
| spellingShingle | Clemens Becker Kilian Rapp Dietrich Rothenbacher Claudia Schulz Hans-Helmut König Gisela Büchele Acute care models for hip fracture treatment vs post-acute rehabilitation services in older adults after hip fracture: A comparative claims data analysis from Germany Journal of Rehabilitation Medicine hip fracture health services for the aged disability care dependency nursing home mortality rehabilitation hospitalization. |
| title | Acute care models for hip fracture treatment vs post-acute rehabilitation services in older adults after hip fracture: A comparative claims data analysis from Germany |
| title_full | Acute care models for hip fracture treatment vs post-acute rehabilitation services in older adults after hip fracture: A comparative claims data analysis from Germany |
| title_fullStr | Acute care models for hip fracture treatment vs post-acute rehabilitation services in older adults after hip fracture: A comparative claims data analysis from Germany |
| title_full_unstemmed | Acute care models for hip fracture treatment vs post-acute rehabilitation services in older adults after hip fracture: A comparative claims data analysis from Germany |
| title_short | Acute care models for hip fracture treatment vs post-acute rehabilitation services in older adults after hip fracture: A comparative claims data analysis from Germany |
| title_sort | acute care models for hip fracture treatment vs post acute rehabilitation services in older adults after hip fracture a comparative claims data analysis from germany |
| topic | hip fracture health services for the aged disability care dependency nursing home mortality rehabilitation hospitalization. |
| url |
https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-2630
|
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