Conceptual Framework for an Episode of Rehabilitative Care After Surgical Repair of Hip Fracture

Author:

Sheehan Katie J1ORCID,Smith Toby O2,Martin Finbarr C3,Johansen Antony4,Drummond Avril5,Beaupre Lauren6,Magaziner Jay7,Whitney Julie8,Hommel Ami9,Cameron Ian D10,Price Iona11,Sackley Catherine8

Affiliation:

1. Department of Population Health Sciences, School of Population Health and Environmental Sciences, King's College London, London SE1 1UL, United Kingdom

2. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom

3. Medical Gerontology, King's College London

4. Trauma Unit, University Hospital of Wales, Cardiff, United Kingdom

5. School of Health Sciences, University of Nottingham, Nottingham, United Kingdom

6. Department of Physical Therapy and Division of Orthopaedic Surgery, University of Alberta, Edmonton, Canada

7. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland

8. Department of Population Health Sciences, School of Population Health and Environmental Sciences, King's College London

9. Faculty of Health and Society, Malmö University, Malmö, Sweden

10. John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia

11. Royal College of Physicians Patient and Carer Network, London, United Kingdom

Abstract

Abstract Researchers face a challenge when evaluating the effectiveness of rehabilitation after a surgical procedure for hip fracture. Reported outcomes of rehabilitation will vary depending on the end point of the episode of care. Evaluation at an inappropriate end point might suggest a lack of effectiveness leading to the underuse of rehabilitation that could improve outcomes. The purpose of this article is to describe a conceptual framework for a continuum-care episode of rehabilitation after a surgical procedure for hip fracture. Definitions are proposed for the index event, end point, and service scope of the episode. Challenges in defining the episode of care and operationalizing the episode, and next steps for researchers are discussed. The episode described is intended to apply to all patients eligible for entry to rehabilitation after hip fracture and includes most functional recovery end points. This framework will provide a guide for rehabilitation researchers when designing and interpreting evaluations of the effectiveness of rehabilitation after hip fracture. Evaluation of all potential care episodes facilitates transparency in reporting of outcomes, enabling researchers to determine the true effectiveness of rehabilitation after a surgical procedure for hip fracture.

Funder

NIH

Publisher

Oxford University Press (OUP)

Subject

Physical Therapy, Sports Therapy and Rehabilitation

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