Hip Fracture in the Elderly: Impact, Recovery, and Early Geriatric Nursing Home Rehabilitation

The aim of the study, described in this thesis, was to determine the effect of early discharge from the acute hospital of elderly hip fracture patients on functional status, mortality, quality of life, complications and costs. Secondary aims were to provide a detailed description of the consequences of hip fracture for the elderly in regard to survival, recovery of function, and the occurrence of complications and to determine which of the 4 used measurement instruments are most appropriate in the follow-up of function and quality of life after hip fracture. The main conclusions are: 1. A hip fracture still has serious consequences in regard to survival, recovery of function and quality of life, and postoperative complications; 2. Early discharge from hospital does not improve or worsen this outcome at 4 months after fracture; 3. Early discharge causes a modest real cost saving which did not reach statistical significance in the present study. We recommend the intensification of the cooperation between hospitals and nursing homes with the aim of further reducing the hospital stay because of possibly favorable consequences for the waiting lists for orthopedic surgery. We suggest organizing the care of hip fracture patients in specialized hip fracture services.