ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2017
Variation in Functional Status After Hip Fracture: Facility and Regional Influence on Mobility and Self-Care.
Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- Development and Evaluation of Rehabilitation Service Areas for the United States.BMC health services research · 2023Article
- Understanding Variation in Postacute Care: Developing Rehabilitation Service Areas Through Geographic Mapping.American journal of physical medicine & rehabilitation · 2021Article
- Regional variation of care dependency after hip fracture in Germany: A retrospective cohort study using health insurance claims data.PloS one · 2020Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundRecent reports show substantial geographic variation in postacute health care spending. Little is known about variation in functional outcomes after postacute rehabilitation for patients with hip fracture. We examined variation in mobility and self-care after hip fracture rehabilitation across inpatient rehabilitation facilities (IRFs), hospital referral regions (HRRs) and states.
methodsRetrospective cohort study using data from the Centers for Medicare and Medicaid Services (CMS) from 2006 to 2009. Study sample included 149,258 records from patients 66 years and older at 1,166 IRFs located within 292 HRRs and across 50 states. Hip fracture cases were defined by CMS impairment group codes (08.11, 08.12). Hierarchical generalized linear models were used to assess discharge mobility and self-care functional status, adjusting for individual patient characteristics and the random effect of IRFs, HRRs, and states.
resultsVariation in discharge mobility status as assessed by the intraclass correlation percentage (ICC%) was 8.8% across IRFs, 4.0% across HRRs, and 1.8% across states. For self-care, the ICCs were 10.2% across IRFs, 4.8% across HRRs, and 2.4% across states. The range of discharge mobility scores (maximum functional status rating to minimum functional status rating) showed a 9.6-point difference for IRFs, 6.5 for regions, and 2.6 for states. Range of discharge self-care scores were 13.1 for IRFs, 6.8 for HRRs, and 3.4 for states.
conclusionVariation in functional status following postacute hip fracture rehabilitation appears to occur primarily at the level of facilities rather than geographic location.
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