Abstract
Abstract Background The aim of this study was to compare hip fracture rehabilitation outcomes during the COVID-19 pandemic (2020 data) against comparable control data (2015–2019). Variables examined included patient demographics, time to transfer (acute length of stay), rehabilitation length of stay and discharge destination. Methods An audit was completed using the local anonymised hip fracture data collected during 2020. This data is collected as part of an ongoing quality improvement initiative to improve the hip fracture rehabilitation pathway. A review of previous local annual hip fracture reports was completed to allow comparison of key outcomes. Results For the control period (2015–2019) the mean number of hip fractures admitted per year was 98 compared to 59 during 2020 (periods of closure). During the control period, 78% of admissions were female and mean age was 82 which is similar to 2020 with 83% females mean age of 83. Almost half of patients lived alone (49%) which is similar to the control period (48%). Despite the added complexity to the transfer process (swabbing and isolation) the mean time to transfer from acute was reduced by 1 day. The mean post-acute rehabilitation length of stay significantly reduced in 2020 to 37 days compared to 49 days during the control period. There was a reduction in number of patients who discharged home, 88% in 2020 compared to 93% in control period. This is reflected in the increased number who discharged to nursing home care, 7% in 2020 compared to 4% in control period. Conclusion There may be multiple contributing factors that led to the significant reduction in rehabilitation length of stay including increased rehabilitation staffing ratios during the pandemic due to reduced occupancy, expedited home support services, increased community response teams and patient and family wish to accelerate discharge secondary to concerns of risk of COVID-19 exposure in the hospital setting.
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