Patient trajectories in older patients with hip fractures

Hip fracture is a critical life event that often causes functional decline, nursing home admission and early death. Most hip fracture patients are in need of postoperative rehabilitation services. Through the Coordination Reform, the municipalities in Norway were given increased responsibility for community-based treatment and rehabilitation after surgery.

The purpose of this study was to examine associations between municipal resources and patient outcomes through the first year after a hip fracture, focusing on survival and health-related quality of life.

We conducted a nationwide cohort study on 15,757 patients (mean age 81 years, 69% women) experiencing a hip fracture in 2011–2012 in Norway, with a 1-year follow-up. We obtained data on date of hip fracture, demographics, total morbidity (ASA) score, health-related quality of life (EQ-5D-3 L), date of death if applicable, municipality of residence (Norwegian Hip Fracture Register), date of hospital readmission due to complications (Norwegian Patient Register), and information on municipalities’ characteristics (Municipality-State-Reporting).