Integrated care pathway for hip fractures in a subacute rehabilitation setting

• Published in: Annals of the Academy of Medicine, Singapore Vol. 42; no. 11; pp. 579 - 584
• Main Authors: Chong, Tsung Wei, Chan, Gribson, Feng, Liang, Goh, Susie, Hew, Agnes, Ng, Tze Pin, Tan, Boon Yeow
• Format: Journal Article
• Language: English
• Published: Singapore 01.11.2013
• Subjects: Hip Fractures; Humans; Prospective Studies
• ISSN: 0304-4602; 0304-4602
• DOI: 10.47102/annals-acadmedsg.V42N11p579

The effectiveness of integrated care pathways for hip fractures in subacute rehabilitation settings is not known. The study objective was to assess if a hip fracture integrated care pathway at a subacute rehabilitation facility would result in better functional outcomes, shorter length of stay and fewer institutionalisations. A randomised controlled trial on an integrated care pathway for hip fracture patients in a subacute rehabilitation setting. Modified Barthel Index, ambulatory status, SF-12, length of stay, discharge destination, hospital readmission and mortality were measured. Followup assessments were up to 1 year post-hip fracture. There were no significant differences in Montebello Rehabilitation Factor Scores and proportions achieving premorbid ambulatory status at discharge, 6 months and 12 months respectively. There was a significant reduction in the median length of stay between the control group at 48.0 days and the intervention group at 35.0 days (P = 0.009). The proportion of readmissions to acute hospitals was similar in both groups up to 1 year. There were no significant differences for nursing home stay up to 1 year post-discharge and mortality at 1 year. Our study supports the use of integrated care pathways in subacute rehabilitation settings to reduce length of stay whilst achieving the same functional gains.