This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow Rights and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by KOVAL, K. J.
Right arrow Articles by ZUCKERMAN, J. D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by KOVAL, K. J.
Right arrow Articles by ZUCKERMAN, J. D.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Facebook   Add to Technorati   Add to Twitter  
What's this?
The Journal of Bone and Joint Surgery 80:357-64 (1998)
© 1998 The Journal of Bone and Joint Surgery, Inc.

Effect of Acute Inpatient Rehabilitation on Outcome after Fracture of the Femoral Neck or Intertrochanteric Fracture*

KENNETH J. KOVAL, M.D.{dagger}, GINA B. AHARONOFF, M.P.H.{dagger}, EDWARD T. SU, B.S.{dagger} and JOSEPH D. ZUCKERMAN, M.D.{dagger}, NEW YORK, N.Y.

Investigation performed at the Department of Orthopaedic Surgery, Hospital for Joint Diseases, New York City

A study was performed to assess the impact of intensive inpatient rehabilitation on the outcome after a fracture of the femoral neck or an intertrochanteric fracture. Before 1990, our hospital did not have an inpatient rehabilitation program. On January 1, 1990, a diagnosis-related-group-exempt (DRG-exempt) acute rehabilitation program was initiated. Patients were discharged to this program after evaluation by a staff physiatrist. Before 1990, twenty-seven (9.0 per cent) of 301 patients were discharged to an outside rehabilitation facility. After January 1990, the percentage of patients who were discharged to the DRG-exempt program increased yearly, from nineteen (17 per cent) of 113 patients in 1990 to forty-one (64 per cent) of sixty-four patients in 1993; this difference was significant (p < 0.01). Before 1990, the average duration of the stay in the hospital was 21.9 days. After January 1990, the average duration for the patients who did not enter the rehabilitation program was 20.0 days whereas the average duration for those who did was 31.4 days (16.1 days for acute care and 15.6 days for the rehabilitation program). There were no differences in the hospital discharge status or in the walking ability, place of residence, need for home assistance, or independence in basic and instrumental activities of daily living at the six and twelve-month follow-up examinations between patients who had been managed before initiation of the rehabilitation program and those managed after it or between patients who had been discharged to this program after its initiation and those who had not. These results raise serious questions regarding the global cost-effectiveness of these programs for patients who have had a fracture of the femoral neck or an intertrochanteric fracture.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Facebook Facebook   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 CMAJHome page
G. Naglie, C. Tansey, J. L. Kirkland, D. J. Ogilvie-Harris, A. S. Detsky, E. Etchells, G. Tomlinson, K. O'Rourke, and B. Goldlist
Interdisciplinary inpatient care for elderly people with hip fracture: a randomized controlled trial
Can. Med. Assoc. J., July 1, 2002; 167(1): 25 - 32.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
P. Haentjens, P. Autier, M. Barette, and S. Boonen
The Economic Cost of Hip Fractures Among Elderly Women : A One-Year, Prospective, Observational Cohort Study with Matched-Pair Analysis
J. Bone Joint Surg. Am., April 1, 2001; 83(4): 493 - 493.
[Abstract] [Full Text]