Analysis of the practices and influencing factors of referral to inpatient rehabilitation following hip fractures based on data from the Hungarian healthcare funding database

Abstract

Introduction: Hip fractures heavily burden healthcare systems in aging populations. The health and quality of life of the patients depend not only on the acute care, but on rehabilitation practices as well. There is insufficient data on Hungarian rehabilitation rates following hip fracture surgeries. Objective: Our goal was to examine the rehabilitation rates within 30 days of hip fracture related admissions and to observe the factors that influence admission to inpatient rehabilitation. Method: We analysed patient level data from the Hungarian healthcare funding database between 2005 and 2015 by multivariate logistic regression, and observed rehabilitation rates through descriptive statistics between 2005 and 2015 and between 1 January 2019 and 31 December 2020. Results: Rehabilitation rates show a rapid increase between 2005 and 2015, and further increase is observed in 2019, while 2020 shows a fall in admission rates. The regression analysis showed significant results for the patients' gender, age, and the variables assessing healthcare practices and accessibility. Complications after the acute care has a strong power on admission to rehabilitation, but the majority of the observed comorbidities have significant effects as well. Conclusion: Admission to rehabilitation after hip fracture shows increasing trends. Factors influencing the admissions show a consistent direction but changing strength. The increasing strength of our regression model suggests that rehabilitation practices grew more consistent over time.