Abstract

Objective: To identify functional changes associated with home discharge among patients admitted to a convalescent rehabilitation hospital after hip fracture surgery.
Methodology: This retrospective cohort study included 225 postoperative hip fracture patients admitted for convalescent rehabilitation. Balance, ambulation, cognition, and activities of daily living were assessed at admission and before discharge using the BBS, FAC, MMSE, and MBI. Change scores were compared between the home-discharge and non-home-discharge groups. Change-based logistic regression analyses were performed to examine factors independently associated with home discharge. An additional item-level analysis evaluated associations between changes in individual MBI items and home discharge.
Results: The home-discharge group showed greater improvements in BBS, FAC, and total MBI than the non-home-discharge group. In the change-based multivariable model, improvements in FAC and total MBI remained independently associated with home discharge. At the item level, improvements in toilet use, bladder control, and mobility/ambulation items were significantly associated with home discharge.
Conclusion: Home discharge after hip fracture surgery was primarily associated with concurrent gains in ambulation and ADL independence. Early discharge planning using structured assessment and goal-oriented interventions targeting mobility and continence-related ADL tasks may facilitate safe and sustainable home discharge.

Key words: Hip fracture, functional change, convalescent, rehabilitation.