Healthcare Quarterly

Healthcare Quarterly 7(2) March 2004 : 49-53.doi:10.12927/hcq..16629
Ideas at Work

Effect of Home Care Service Levels on Health Outcomes in Hip Fracture Patients in Alberta

Marilyn W. Cree, Angela G. Juby and Keumhee C. Carriere


During the 1990s, the number of Canadians requiring post-acute home care services rose as Canadian hospitals attempted to improve discharge procedures (MacAdam 2002). In Manitoba, for example, the proportion of clients using post-acute home care services increased from 7.7% in 1995/1996 to 9.4% in 1998/1999 (Roos et al. 2001), an increase of 22% over three years.

The need for post-acute home care services has traditionally been very high among the frail elderly who are hospitalized with disabling conditions such as hip fracture. A recent Alberta study reported approximately two-thirds of hip fracture patients received home care services during the 90 days following their discharge (Maxwell et al. 2001). Although these patients often require substantive amounts of rehabilitative treatment to resume independent living in the community, we don't how much or what type of home care assistance they actually receive. More importantly, we don't know if high service levels are associated with reduced long-term care placement or improved health outcomes.

One purpose of this study was to describe the post-acute home care services received by a cohort of hip fracture patients. Our second objective was to explore the effect of home care service levels on institutional care, physical function, morbidity, health perception and mortality. In the absence of experimental evidence outlining the appropriate intervention for each patient, this study examines whether the current system is benefiting patients. As the population ages and home care use increases, this is an important first step in effectively using healthcare resources to improve patient health.



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