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Winnipeg Free Press - PRINT EDITION
Study touts home care for hip-replacement patients
TORONTO -- Elderly patients given formal home care after a hip replacement due to a fall have a lower risk of dying within a few months after leaving hospital compared to those who don't get such follow-up services, a study suggests.
Researchers at McGill University in Montreal found the death rate among Quebec patients provided home care after emergency hip replacement was 43 per cent lower than for those sent home without a program in place.
Lead author Elham Rahme, an associate professor of biostatistics and epidemiology, said elderly patients who can be discharged home -- as opposed to being sent to a nursing home or another hospital -- often have difficulties with mobility and need monitoring and rehabilitation.
"They need somebody to care for them, and most of the time the person they live with is as old as they are and they cannot provide sufficient care," she said Monday from Montreal.
The study, in the Canadian Medical Association Journal, looked at hospital and other administrative records for more than 11,300 patients who had a single hip replacement, most as the result of a fall that caused a hip fracture.
Almost one-third of the patients were discharged home without follow-up services, said Rahme, noting that only six per cent were sent home with services in place to provide rehabilitation and other therapy. That meant only 16 per cent of those able to return home had follow-up home care, she said.
Rahme said home-care programs in Quebec are insufficient to meet patient needs, but she suspects there may also be shortfalls in other provinces.
Dr. Alan Forster, medical director of the Ottawa Hospital Center for Patient Safety, agreed that visits by a home-care team that might include a nurse, rehabilitation therapists and nutritionist are valuable in getting patients back on their feet. But Forster questioned the high impact on death rates from home care that the researchers found.
He suggested that following actual patients after their surgery -- instead of using only hospital and other records -- may produce more scientifically "robust" results.
-- The Canadian Press
Republished from the Winnipeg Free Press print edition August 17, 2010 A7
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