Purpose
To estimate the 1-year all-cause mortality rates for hip fracture (HFx) patients hospitalized
at Veterans Health Administration (VHA) facilities and compare with previous published
mortality rates for veterans treated in Medicare facilities.
Methods
In total, 7 years of VHA discharge data on HFxs for 12,539 patients age 65 and older
were combined with national death registry data. We performed a 1-year survival analysis
using the Cox proportional hazard method.
Results
The adjusted rates for veterans treated in the VHA (30 days=9.3%, 90 days=17.5%, 180 days=23.3%, 365 days=29.8%) were similar to veterans treated in Medicare facilities (30 days=8.9%, 90 days=15.6%, 180 days=21.8%, 365 days=29.9%). For veterans treated for a HFx in Medicare facilities, the average length
of stay was 7 days and 49% were discharged to a nursing home. Veterans treated in
the VHA had an average length of stay of 14 days and only 35% were discharged to a
nursing home.
Conclusions
Our study suggests no difference in HFx-adjusted mortality rates between the VHA and
Medicare facilities. Given the institutional factor differences between Medicare and
the VHA, future study and comparison of health outcomes for nursing home HFx patients
and related costs between these two health care programs may contribute to the on-going
health care reform debate.
Keywords
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Article info
Publication history
Published online: January 06, 2010
Footnotes
The authors have no conflicts of interest pertaining to this article.
Identification
Copyright
Published by Elsevier Inc.
