Researcher examines rehabilitative care for hip fractures in veterans

With limited resources available for postoperative care, there is some debate regarding the most effective setting for patient recovery following surgical treatments. This is particularly true for our nation’s veterans and treatment for hip fractures since recovery generally requires rehabilitation services. However, there are no established guidelines for determining the best care setting. 

Tiffany Radcliff, Ph.D., associate professor at the Texas A&M Health Science Center School of Rural Public Health, co-authored a study recently published in the Journal of Rehabilitation Research and Development that modeled patients’ settings for post-hip fracture rehabilitative care and what factors play the largest role. 

“Approximately 1,200 hip fracture surgeries are performed every year in VA hospitals,” said Radcliff. “Veterans with hip fractures are a clinically important subset of patients who usually require rehabilitation care following surgery.” According to Radcliff, we often think of frail older women having hip fractures. Most veterans with hip fractures are men and they tend to be younger and sicker than patients treated in other care systems. 

The study entitled, “Determinants of postsurgical discharge setting for male hip fracture patients,” is the fourth publication from a grant awarded to Radcliff by the U.S. Department of Veteran Affairs (VA) Health Services Research and Development. 

According to this study, nearly half of the VA’s hip fracture patients were discharged and sent home without VA provided rehabilitative care. However, the most vulnerable patients, including those with complications from surgery, high comorbidity scores or with limited access to non-VA care resources were more likely to be discharged to inpatient rehabilitation care or other non-home settings following hip fracture repair. Further studies will be needed to determine whether there is a clear link between rehabilitation setting and longer-term health outcomes. 

Other authors include Matthew Maciejewski, Ph.D., of the Durham VA Medical Center and Department of Medicine, Duke University, Durham, NC; William Henderson, Ph.D., from the University of Colorado Health Outcomes Program, Aurora, Colo.; Diane Cowper Ripley, Ph.D. and W. Bruce Vogel, Ph.D., both of the North Florida/South Georgia VA Health System in Gainesville, Fla.; Elizabeth Regan, M.D., Ph.D., from the National Jewish Healthcare, Denver, Colo., and Evelyn Hutt, M.D., from the VA Eastern Colorado Healthcare System and Division of General Internal Medicine, University of Colorado Denver, Aurora, Colo.