Prospective cohort study finds similar functional recovery between inpatient postacute care and home support after hip fracture surgery, indicating home care is an effective alternative.
Key Points
To compare 1-year functional recovery trajectories and postoperative complication rates between older hip fracture patients receiving inpatient postacute care and those discharged home with community-based long-term care.
Prospective cohort study of patients aged ≥65 years undergoing hip fracture surgery allocated by preference to inpatient postacute care (n = 34) or direct discharge home with Long-Term Care 2.0 services (n = 45).
Functional recovery was evaluated across five time points over 1 year using the Barthel index and Harris hip score, analyzed with generalized estimating equations alongside complication, readmission, and mortality tracking.
Both groups exhibited significant functional gains over time (P < 0.001), with generalized estimating equation analysis demonstrating no significant between-group differences in 1-year recovery trajectories for activities of daily living (P = 0.393) or hip function (P = 0.638).
No significant differences were observed between inpatient care and home-based care groups regarding overall complication rates, emergency department visits, hospital readmissions, or 1-year mortality.
Older age and higher Charlson comorbidity index scores significantly predicted poorer functional recovery, whereas male sex was associated with superior outcomes.