Effect of Inpatient Quality of Care on Functional Outcomes in Patients With Hip Fracture

Bibliographic Data

ID9102783
AuthorsAlbert L Siu (0000-0001-6330-8502, Icahn School of Medicine at Mount Sinai, corresponding author), Kenneth S Boockvar (0000-0003-1165-5558, Geriatric Research Education and Clinical Center, corresponding author), Joan D Penrod (Icahn School of Medicine at Mount Sinai, corresponding author), R Sean Morrison (0000-0003-0830-5100, Geriatric Research Education and Clinical Center, corresponding author), Ethan A Halm (0000-0003-3042-2741, Icahn School of Medicine at Mount Sinai, corresponding author), Ann Litke (Icahn School of Medicine at Mount Sinai, corresponding author), Stacey B Silberzweig (Icahn School of Medicine at Mount Sinai, corresponding author), Jeanne Teresi, Jeanne A Teresi (Hebrew Home), Katja Ocepek-Welikson, Katja Ocepek‐Welikson (Hebrew Home), Jay Magaziner (University of Maryland, Baltimore)
Year2006
Volume44
Issue9
Pages862-869
Publication date2006-09-01
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/01.mlr.0000223738.34872.6a
PMID16932138
PMCIDPMC3033757
OpenAlexW2152820713
LanguageEN
Citations received1
References cited38

OBJECTIVES: We sought to examine the relationship between functional outcome and process of care for patients with hip fracture. RESEARCH DESIGN AND PARTICIPANTS: We undertook a prospective cohort study in 4 hospitals of 554 patients treated with surgery for hip fracture. MEASUREMENTS: Information on patient characteristics and processes of hospital care collected from the medical record, interviews, and bedside observations. Follow-up information obtained at 6 months on function (using the Functional Independence Measure [FIM]), survival, and readmission. RESULTS: Individual processes of care were generally not associated with adjusted outcomes. A scale of 9 processes related to mobilization was associated with improved adjusted locomotion (P = 0.006), self care (P = 0.022), and transferring (P = 0.007) at 2 months, but the benefits were smaller and not significant by 6 months. These processes were not associated with mortality. The predicted value for the FIM locomotion measure (range, 2-14) at 2 months was 5.9 (95% confidence interval 5.4-6.4) for patients at the 10th percentile of performance on these processes compared with 7.1 (95% confidence interval 6.6, 7.6) at the 90th percentile. Patients who experienced no hospital complications and no readmissions retained the benefits in locomotion at 6 months. Anticoagulation processes were associated with improved transferring at 2 months (P = 0.046) but anticoagulation and other processes of care were not otherwise associated with improved function. DISCUSSION: Our findings indicate the need to attend to all steps in the care of patients with hip fracture. Additionally, functional outcomes were more sensitive markers of improved process of care, compared with 6-month mortality, in the case of hip fracture

Cohort study · Confidence interval · Hip fracture · Osteoporosis · Percentile · Percentile rank · Physical therapy · Prospective cohort study · Quality of life (healthcare) · Emergency Medicine · Hip and Femur Fractures · Internal Medicine · Medicine · Nursing · Nutrition and Health in Aging · Surgery · Total Knee Arthroplasty Outcomes

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