Pre-discharge rehabilitation after hip surgery reduces 30-day readmissions in older adults: National Health Insurance Service-Senior Cohort (2007-2012)

초록

Background: Rehabilitation programs before and after hip surgery can shorten the length of hospital stay, reduce the incidence of complications, and reduce the readmission rate after surgery in older adults aged 65 years or over. The present study aimed to investigate the status of readmissions within 30 days after discharge and related factors in elderly people through the big data analysis using the sample data from the National Health Insurance Service-Senior Cohort (NHIS-SC). Method: The subjects of the present study were patients aged 65 years or older who underwent hip surgery between 2007 and 2012. The subjects undergoing hip surgery included those who underwent at least one surgery of the following during the period: replacement arthroplasty, revision arthroplasty, arthrodesis, internal fixation, reduction of fractured extremity and internal fixation. Each variable was selected for sociodemographic characteristics and clinical features of the subjects, and the characteristics of medical institutions according to 30-day readmission. Results: Among 9008 study participants, 1628 (18.1%) were readmitted within 30 days. Lower readmission rate was associated with longer hospital stay, greater number of hospital beds, and rehabilitation before discharge; whereas a higher rate was associated with provincially located hospitals, getting of medical aid, accompanying fractures, ICU admission, and comorbidities. Conclusions: Pre-discharge rehabilitation in patients aged >= 65 years who underwent hip surgery can reduce readmissions, and efforts to increase daily living functions such as muscle strength and walking ability are very important. (C) C 2017 Published by Elsevier Masson SAS.

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