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Variation in access to community rehabilitation services and length of stay in hospital following a hip fracture: a cross-sectional study

OBJECTIVES: To assess variation in access to and use of community rehabilitation services for patients with a hip fracture, and whether this affects length of stay in hospital. DESIGN: Cross-sectional study using administrative patient-level data from Hospital Episode Statistics (HES) and organisati...

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Autores principales: Neuburger, Jenny, Harding, Karen A, Bradley, Rachel J D, Cromwell, David A, Gregson, Celia L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4160836/
https://www.ncbi.nlm.nih.gov/pubmed/25208849
http://dx.doi.org/10.1136/bmjopen-2014-005469
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author Neuburger, Jenny
Harding, Karen A
Bradley, Rachel J D
Cromwell, David A
Gregson, Celia L
author_facet Neuburger, Jenny
Harding, Karen A
Bradley, Rachel J D
Cromwell, David A
Gregson, Celia L
author_sort Neuburger, Jenny
collection PubMed
description OBJECTIVES: To assess variation in access to and use of community rehabilitation services for patients with a hip fracture, and whether this affects length of stay in hospital. DESIGN: Cross-sectional study using administrative patient-level data from Hospital Episode Statistics (HES) and organisational survey data. SETTING: A regional health economy in South West England served by four acute National Health Service (NHS) hospital trusts and six former Primary Care Trusts (PCTs). POPULATION: 1230 hip fracture patients treated in an acute hospital between 1 April 2011 and 29 February 2012. MAIN OUTCOMES: Information about access to community rehabilitation services for each acute hospital and PCT, reported by organisational survey. Rates of patients transferred from acute hospital to community rehabilitation hospitals (CRH) across eight groups with varying access; determined by acute hospital and PCT. Median lengths of stay in the acute hospital, and in the acute hospital plus CRH combined. Associations between the rate of transfer to a CRH and median lengths of stay assessed using Spearman's rank correlation coefficient (r(s)). RESULTS: Access to community rehabilitation services varied, including the number of CRH inpatient beds, formal access criteria and waiting times. In one PCT, no home-based rehabilitation service was available. The percentage of patients transferred to a CRH ranged from 2.1% to 54.7%. A higher transfer rate was associated with a shorter median length of stay in the acute hospital (r(s)=−0.8; p=0.01), but a longer median combined length of stay in the acute hospital and CRH (r(s)=+0.7; p=0.04). CONCLUSIONS: Within one geographical area, there was wide variation in availability and use of community rehabilitation services for patients discharged from an acute hospital following a hip fracture. Reliance on transfers to community rehabilitation hospitals was associated with a longer length of stay in the NHS.
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spelling pubmed-41608362014-09-16 Variation in access to community rehabilitation services and length of stay in hospital following a hip fracture: a cross-sectional study Neuburger, Jenny Harding, Karen A Bradley, Rachel J D Cromwell, David A Gregson, Celia L BMJ Open Health Services Research OBJECTIVES: To assess variation in access to and use of community rehabilitation services for patients with a hip fracture, and whether this affects length of stay in hospital. DESIGN: Cross-sectional study using administrative patient-level data from Hospital Episode Statistics (HES) and organisational survey data. SETTING: A regional health economy in South West England served by four acute National Health Service (NHS) hospital trusts and six former Primary Care Trusts (PCTs). POPULATION: 1230 hip fracture patients treated in an acute hospital between 1 April 2011 and 29 February 2012. MAIN OUTCOMES: Information about access to community rehabilitation services for each acute hospital and PCT, reported by organisational survey. Rates of patients transferred from acute hospital to community rehabilitation hospitals (CRH) across eight groups with varying access; determined by acute hospital and PCT. Median lengths of stay in the acute hospital, and in the acute hospital plus CRH combined. Associations between the rate of transfer to a CRH and median lengths of stay assessed using Spearman's rank correlation coefficient (r(s)). RESULTS: Access to community rehabilitation services varied, including the number of CRH inpatient beds, formal access criteria and waiting times. In one PCT, no home-based rehabilitation service was available. The percentage of patients transferred to a CRH ranged from 2.1% to 54.7%. A higher transfer rate was associated with a shorter median length of stay in the acute hospital (r(s)=−0.8; p=0.01), but a longer median combined length of stay in the acute hospital and CRH (r(s)=+0.7; p=0.04). CONCLUSIONS: Within one geographical area, there was wide variation in availability and use of community rehabilitation services for patients discharged from an acute hospital following a hip fracture. Reliance on transfers to community rehabilitation hospitals was associated with a longer length of stay in the NHS. BMJ Publishing Group 2014-09-10 /pmc/articles/PMC4160836/ /pubmed/25208849 http://dx.doi.org/10.1136/bmjopen-2014-005469 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Health Services Research
Neuburger, Jenny
Harding, Karen A
Bradley, Rachel J D
Cromwell, David A
Gregson, Celia L
Variation in access to community rehabilitation services and length of stay in hospital following a hip fracture: a cross-sectional study
title Variation in access to community rehabilitation services and length of stay in hospital following a hip fracture: a cross-sectional study
title_full Variation in access to community rehabilitation services and length of stay in hospital following a hip fracture: a cross-sectional study
title_fullStr Variation in access to community rehabilitation services and length of stay in hospital following a hip fracture: a cross-sectional study
title_full_unstemmed Variation in access to community rehabilitation services and length of stay in hospital following a hip fracture: a cross-sectional study
title_short Variation in access to community rehabilitation services and length of stay in hospital following a hip fracture: a cross-sectional study
title_sort variation in access to community rehabilitation services and length of stay in hospital following a hip fracture: a cross-sectional study
topic Health Services Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4160836/
https://www.ncbi.nlm.nih.gov/pubmed/25208849
http://dx.doi.org/10.1136/bmjopen-2014-005469
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