Background
Methods
Ethical approval and funding source
Sampling and hospital recruitment
Patient enrolment and eligibility
Data collection
Complications
Outcomes
Rehabilitation ‘type’ | Unit charge | Comments |
---|---|---|
Inpatient rehabilitation, per night | $700 | Based on 2015 private health insurance reimbursement figures. Note: The Australian Public Hospital Cost Report 2013 [46] cites $967.29 per night government. The figure used in this study was considered conservative. |
Day Hospital, per visit | $255.15 | Based on The Australian Public Hospital Cost Report 2013 [46] (clinic code 40.12, pg 112). |
Private physiotherapy clinic visit | $74.90 | Based on COMCARE 2015 [47] rates for a standard consultation or return visit. Same charge was applied regardless of group-based on one-to-one based care. |
Domiciliary (hospital in the home) visit | $87.10 | COMCARE 2015 [47] rate for a standard visit was used. |
Physiotherapy supervised hydrotherapy visit | $74.90 | Based on COMCARE 2015 [47] rates. Same charge was applied regardless of group-based or one-to-one based care. |
Analysis
Results
Unmatched cohort
Unmatched versus matched cohorts
Inpatient Rehabilitation Group, n = 141 | No Inpatient Rehabilitation Group, n = 290 | Standardized Mean Difference | P-value | |
---|---|---|---|---|
Age, mean (SD), y | 68.7 (9.9) | 63.7 (10.4) | 0.50 | < 0.001 |
Male, % (n) | 68.1 (96) | 47.6 (138) | 0.42 | < 0.001 |
BMI, mean (SD) | 27.7 (4.9) | 28.2 (4.9) | 0.11 | 0.27 |
Education, % (n) | ||||
1 | 1.4 (2) | 1.4 (4) | 0.0 | 0.97 |
2 | 21.3 (30) | 18.3 (53) | 0.08 | 0.46 |
3 | 56.7 (80) | 51.4 (149) | 0.11 | 0.30 |
4 | 20.6 (29) | 29.0 (84) | 0.20 | 0.06 |
ASA, % (n) | ||||
1 | 9.2 (13) | 19.1 (55) | 0.29 | 0.009 |
2 | 54.6 (77) | 62.2 (180) | 0.15 | 0.14 |
3 | 33.3 (47) | 17.4 (50) | 0.37 | < 0.001 |
4 | 2.8 (4) | 1.4 (4) | 0.10 | 0.30 |
Comorbidity, % (n) | ||||
Nil | 8.5 (12) | 21.7 (63) | 0.38 | < 0.001 |
Yes, but no daily medication | 5.0 (7) | 11.4 (33) | 0.24 | 0.03 |
Yes, with daily medication | 86.5 (122) | 66.9 (194) | 0.48 | < 0.001 |
Oxford Hip Score, mean (SD) | 22.3 (9.2) | 24.4 (8.6) | 0.24 | 0.02 |
EuroQol VAS, mean (SD) | 71.4 (19.0) | 73.5 (16.3) | 0.12 | 0.24 |
Other lower limb or back problems limiting mobility, % (n) | 51.1 (72) | 42.1 (122) | 0.18 | 0.08 |
Anterior surgical approach | 33.8 (48) | 31.0 (90) | 0.06 | 0.56 |
Paid employment, % (n) | 31.2 (44) | 44.1 (128) | 0.27 | 0.01 |
Inpatient Rehabilitation Group, n = 123 | No Inpatient Rehabilitation Group, n = 123 | Standardized Mean Difference | P-value | |
---|---|---|---|---|
Age, mean (SD), y | 67.8 (10.0) | 66.9 (10.6) | 0.09 | 0.48 |
Male, % (n) | 64.2 | 68.3 | 0.09 | 0.50 |
BMI, mean (SD) | 27.8 (4.8) | 28.0 (5.1) | 0.04 | 0.76 |
Education, % (n) | ||||
1 | 1.6 (2) | 1.6 (2) | 0 | 1.0 |
2 | 20.3 (25) | 22.80 (28) | 0.06 | 0.64 |
3 | 55.3 (68) | 51.2 (63) | 0.08 | 0.52 |
4 | 22.8 (28) | 24.4 (30) | 0.04 | 0.76 |
ASA, % (n) | ||||
1 | 10.6 (13) | 7.3 (9) | 0.11 | 0.37 |
2 | 59.4 (73) | 61.0 (75) | 0.03 | 0.79 |
3 | 28.5 (35) | 28.5 (35) | 0.0 | 1.0 |
4 | 1.6 (2) | 3.3 (4) | 0.11 | 0.70 |
Comorbidity, % (n) | ||||
Nil | 8.9 (11) | 8.9 (11) | 0 | 1.0 |
Yes, but no daily medication | 4.9 (6) | 3.3 (4) | 0.08 | 0.52 |
Yes, with daily medication | 86.2 (106) | 87.8 (108) | 0.05 | 0.71 |
Oxford Hip Score, mean (SD) | 23.1 (8.9) | 21.9 (8.2) | 0.14 | 0.27 |
EuroQol VAS, mean (SD) | 71.7 (19.4) | 70.8 (16.8) | 0.05 | 0.69 |
Other lower limb or back problems limiting mobility, % (n) | 47.2 (58) | 48.8 (60) | 0.03 | 0.80 |
Anterior surgical approach | 33.8 (42) | 31.0 (38) | 0.06 | 0.56 |
Paid employment, No. (%) | 34.2 (42) | 31.7 (39) | 0.05 | 0.68 |
Outcomes – Matched cohort only
35 days | 90 days | 365 days | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Inpatient | No Inpatient | P-value | Median difference | Inpatient | No Inpatient | P-value | Median difference | Inpatient | No Inpatient | P-value | Median difference | |
OHS median (IQR) | 46 (41, 48 | 46 (41, 48) | 0.60 | 0 (−3, 3) | 48 (46, 48) | 48 (46, 48) | 0.91 | 0 (−1, 1) | ||||
EQVAS today, median (IQR) | 80 (75, 90) | 85 (80, 90) | 0.24 | 0 (−10, 12) | 85 (80, 95) | 90 (80, 95) | 0.49 | 0 (−10, 10) | 85 (75, 95) | 90 (80, 95) | 0.09 | 5 (−10, 15) |
Rehabilitation costs, $, median (IQR) | 7620 (5796, 10,399) | 0 (0, 225) | < 0.001 | -$7582 (−10,249, −5649) | ||||||||
Rehabilitation costs, $, excluding inpatient costs | $824 (87, 2041) | 0 (0,225) | < 0.001 | -$749 (− 1786, 0) | ||||||||
Time off paid employment > 6 weeks, % (95% CI) | 24 (17, 32) | 21 (15, 30) | 0.66 | -2 (−13, 8) | ||||||||
Carer time off paid employment, Yes/No, % (95%CI) | 13 (8, 21) | 13 (8, 21) | 1.0 | 0 (−8, 8) |
Inpatient Group | No Inpatient Group | |||||
---|---|---|---|---|---|---|
% | No. of visits, mean (sd) | Median | % | No. of visits, mean (sd) | Median | |
Receiving community rehabilitation | 79 | 8.7 (4.5) | 8 | 35 | 5 .4 (3.7) | 5 |
Type of community-based rehabilitation | ||||||
1-to-1 clinic | 36 | 5.6 (4.4) | 5 | 37 | 3.7 (2.4) | 3 |
1-to-1 hydrotherapy | 11 | 6.2 (3.2) | 7 | 11 | 3.3 (1.3) | 3 |
Group-based clinic | 13 | 6.3 (2.9) | 5 | 11 | 5.0 (3.6) | 6 |
Group-based hydrotherapy | 6 | 5.3 (3.8) | 4 | 9 | 4.5 (2.6) | 4 |
Domiciliary | 1 | 1 | 1 | 40 | 6.2 (3.6) | 7 |
Day Hospital program | 62 | 8.7 (3.8) | 8 | 6 | 7.0 (1.4) | 7 |