@article{4e8853240a86442d93eb2de9532a0700,
title = "The impact of the frequency, duration and type of physiotherapy on discharge after hip fracture surgery: a secondary analysis of UK national linked audit data",
abstract = "Summary: Additional physiotherapy in the first postoperative week was associated with fewer days to discharge after hip fracture surgery. A 7-day physiotherapy service in the first postoperative week should be considered as a new key performance indicator in evaluating the quality of care for patients admitted with a hip fracture. Introduction: To examine the association between physiotherapy in the first week after hip fracture surgery and discharge from acute hospital. Methods: We linked data from the UK Physiotherapy Hip Fracture Sprint Audit to hospital records for 5395 patients with hip fracture in May and June 2017. We estimated the association between the number of days patients received physiotherapy in the first postoperative week; its overall duration (< 2 h, ≥ 2 h; 30-min increment) and type (mobilisation alone, mobilisation and exercise) and the cumulative probability of discharge from acute hospital over 30 days, using proportional odds regression adjusted for confounders and the competing risk of death. Results: The crude and adjusted odds ratios of discharge were 1.24 (95% CI 1.19–1.30) and 1.26 (95% CI 1.19–1.33) for an additional day of physiotherapy, 1.34 (95% CI 1.18–1.52) and 1.33 (95% CI 1.12–1.57) for ≥ 2 versus < 2 h physiotherapy, and 1.11 (95% CI 1.08–1.15) and 1.10 (95% CI 1.05–1.15) for an additional 30-min of physiotherapy. Physiotherapy type was not associated with discharge. Conclusion: We report an association between physiotherapy and discharge after hip fracture. An average UK hospital admitting 375 patients annually may save 456 bed-days if current provision increased so all patients with hip fracture received physiotherapy on 6–7 days in the first postoperative week. A 7-day physiotherapy service totalling at least 2 h in the first postoperative week may be considered a key performance indicator of acute care quality after hip fracture.",
keywords = "Audit, Hip fracture, National Hip Fracture Database, Neck of femur, Recovery, Rehabilitation",
author = "A. Goubar and S. Ayis and L. Beaupre and Cameron, {I. D.} and R. Milton-Cole and Gregson, {C. L.} and A. Johansen and Kristensen, {M. T.} and J. Magaziner and Martin, {F. C.} and C. Sackley and E. Sadler and Smith, {T. O.} and B. Sobolev and Sheehan, {K. J.}",
note = "Funding Information: The Chartered Society of Physiotherapy Charitable Trust funding provides salary support for AG, and partial salary support for SA. KS also received funding from the NIHR Research for Patient Benefit and UKRI Future Leaders Fellowship for hip fracture health services research. KS is the Chair and AJ and CG are members of the Scientific and Publications Committee of the Falls and Fragility Fracture Audit Programme which managed the National Hip Fracture Database audit at the Royal College of Physicians. FCM was the funded (2012–2018) board chair and AJ is funded clinical lead of the Falls and Fragility Fracture programme. SA is funded by the NIHR Biomedical Research Centre based at Guy{\textquoteright}s and St Thomas{\textquoteright} NHS Foundation Trust, King{\textquoteright}s College London, and the Chartered Society of Physiotherapy. CS received funding from the National Institutes of Health Research and Dunhill Medical Trust for research not related to the current study. TS received funding from the National Institutes of Health Research for research not related to the current study. CLG receives funding from Versus Arthritis (ref 22086). ES is supported by the NIHR Applied Research Collaboration Wessex. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the Department of Health and Social Care. KL, RMC, JM and MTK declare no conflicts of interest. Funding Information: The authors have received grants from the Chartered Society of Physiotherapy Charitable Trust related to this work (Grant No: PRF/18/A24). Publisher Copyright: {\textcopyright} 2021, The Author(s).",
year = "2021",
month = nov,
day = "8",
doi = "10.1007/s00198-021-06195-9",
language = "English",
volume = "33",
journal = "Osteoporosis International",
issn = "0937-941X",
publisher = "Springer London",
number = "4",
}