Post-acute care use common among fragility fracture patients
MedWire News: Use of post-acute care is "extensive" among patients with fragility fractures, report researchers who say this should not be ignored when considering the overall healthcare burden of fractures.
"Examining healthcare utilization patterns among patients with fractures is necessary to estimate disease burden. However, most utilization studies to date have focused on acute care costs of fractures," note Sara Kaffashian (Hôpital Paul Brousse, Villejuif, France) and colleagues.
To address this, Kaffashian and team examined the use of formal and informal post-acute care in 1116 men and women aged 50 years and older, from the Canadian Multicentre Osteoporosis Study. All patients had sustained hip, vertebral, or nonhip/nonvertebral (NHNV) fractures during the 10-year study period.
Overall, 37.1% of participants reported use of rehabilitative (physiotherapy and occupational therapy) services, while 18.2% reported use of home care services (nurse home visits and homemaker services).
After adjustment for age, gender, comorbidity, and living status, the team found that people with hip fracture were five times were more likely to report using either of these services than were people with NHNV fractures.
"It is likely that the majority of individuals who sustain hip fractures undergo surgery for treatment of their fracture, [which] accounts for the considerably higher use of post-acute resources in this group," they write.
In contrast, individuals with vertebral fracture were 36% less likely to report using any type of formal care than patients with nonhip/nonvertebral fractures. This, say the researchers, could reflect the less severe nature of vertebral fractures, or indicate a gap in formal post-acute care provided to people with such fractures.
Individuals with multiple fractures were twice as likely to use post-acute care resources compared with those with single fractures.
The researchers also note that 47.2% of participants reported use of informal care, that is care delivered by friends and relatives. The proportion of patients that received informal care was highest in the hip fracture group at 64.3%, compared with 38.7% and 44.8% of individuals with vertebral and NHNV fractures, respectively.
Among the informal caregivers, 36.0% had a paying job and 25.0% needed to take at least 1 day off from their job to care for their relative with a fracture.
"Our findings have implications for future economic analyses and policy-making related to care of osteoporotic fractures," conclude the authors in Osteoporosis International.
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By Laura Dean