Home care after hip fracture in a health planning region

Health-care restructuring has increased the focus on integrating health care. Therefore the study purpose was to quantify patient movement from hospital to home care before restructuring occurred in a health planning district. Hospital discharge abstracts and home care records identified patients with a hip fracture who used home care (n = 353). Patients from acute care were more likely than rehabilitation or convalescent inpatients to wait > 3 days for home care after hospital discharge (RR 1.54, 95% CI 1.18, 2.00). Institution-dwellers were more likely than community-dwellers to wait > 3 days for home care (RR 2.35, 95% CI 1.86, 2.97). Home care rehabilitation clients were more likely than non-rehabilitation users to wait > 3 days for home care (RR 2.10, 95% CI 1.42, 3.09). Waiting time for home care is associated with hospital care setting and the home care service utilized. Evaluations of restructuring efforts should consider accounting for these relationships.