Survey of Early Supported Discharge Programmes for Low-Trauma Hip Fracture Patients in Australian Public Hospitals

To investigate the prevalence and characteristics of early supported discharge programmes (ESDP) for low-trauma hip fracture (LTHF) patients.

We distributed a survey exploring hospital and patient demographics, length of stay (LOS), service provision patterns, eligibility criteria and outcome monitoring to 82 public Australian hospitals participating in the Australian and New Zealand Hip Fracture Registry (ANZHFR) (90% national coverage).

Amongst 35 hospitals (response rate 43%), 23 (66%) reported providing Hospital in the Home (HITH) or Rehabilitation in the Home (RITH) programmes, though none were specific to hip fracture. Hospitals offering these programmes had shorter acute length of stay (LOS) compared to those without (9.41 vs. 11.33 days, p = 0.04). The use of HITH/RITH was lower in hospitals where > 30% of patients were from culturally and linguistically diverse (CALD) backgrounds (50% vs. 71%) or where > 25% spoke a language other than English and required a translator (57% vs. 74%). There was variability in ESDP staffing, with physiotherapists (87%), occupational therapists (84%) and nurses (82%) being the most frequently provided. The most common eligibility criterion was living in a geographical area covered by the programme (92%). Outcomes routinely monitored included readmissions (66%), LOS (savings) (61%) and complications (45%).

Early supported discharge programmes are commonly implemented in Australian public hospitals, but programme variability highlights potential inequities in access and service delivery. Standardising programme models and reporting practices, along with incorporating patient and carer-reported outcomes, could enhance the effectiveness of ESDP for LTHF patients.