Comparing home-based and institutional rehabilitation for community-dwelling hip fracture patients: a matched cohort study.

Abstract

Home-based rehabilitation after hip fracture costs less than institutional care, but is care quality comparable? Using Norwegian registry data, we found that patients rehabilitated at home had substantially lower mortality and readmission rates. These findings suggest home-based rehabilitation may offer both economic and clinical advantages. While home-based rehabilitation following hip fracture typically costs less than institutional care, questions remain about care quality equivalence. To compare care quality between home-based and institutional rehabilitation by examining 1-year mortality and 30-day readmission rates among hip fracture patients. We identified 10,790 community-dwelling hip fracture patients aged 60+ from the Norwegian Patient Registry (2018-2019). Patients receiving institutional rehabilitation were matched with those receiving home-based care using propensity score matching. Logistic regression examined treatment effects on outcomes. After propensity score matching, home-based treatment was associated with lower mortality (OR = 0.44; 95% CI, 0.38-0.51) and lower readmission rates (OR = 0.56; 95% CI, 0.49-0.63) compared to treatment at institutions. Community-dwelling hip fracture patients receiving institutional rehabilitation had higher mortality and readmission rates than those treated at home, suggesting superior care quality with home-based treatment.