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The impact of hip fracture on geriatric care and mortality among older swedes: Mapping care trajectories and their determinants
Institute of Environmental Medicine Unit of Epidemiology, Karolinska Institutet, Stockholm, Sweden.
Institute of Environmental Medicine Unit of Epidemiology, Karolinska Institutet, Stockholm, Sweden.
Stockholm University Demography Unit, Stockholm, Sweden.
Intervention and Technology (CLINTEC) Karolinska Institutet Department of Clinical Sciences, Stockholm, Sweden; Karolinska University Hospital Department of Orthopaedics, Stockholm, Sweden.
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2023 (English)In: American Journal of Epidemiology, ISSN 0002-9262, E-ISSN 1476-6256, Vol. 192, no 1, p. 41-50Article in journal (Refereed) Published
Abstract [en]

This study examines the impact of hip fractures on trajectories of home care, care home residence, and mortality among individuals aged 65 and older and explores the impact of living arrangement, cohabitation, frailty, and socioeconomic position on these trajectories. Based on a linkage of nationwide Swedish population registers, our study included 20,573 individuals with first hip fracture in 2014-2015. Care trajectories during two years following the fracture were visualized and compared to two hip fracture-free control groups drawn from the general population; age-and-sex-matched controls and health-matched controls identified through propensity score matching. Multistate modeling was employed to identify sociodemographic and health-related factors associated with care trajectories among hip fracture patients. Already before their fracture, hip fracture patients had worse health than the general population. However, when controlling for pre-fracture health, hip fractures still had a considerable impact on care use and mortality. Comparisons to the health-matched controls suggest that hip fractures have an immediate, yet short-term, impact on care trajectories. Long-term care needs are largely attributable to poorer health profiles independent of the fracture itself. This emphasizes the importance of adequate comparison groups when examining the consequences of diseases which are often accompanied by other underlying health problems.

Place, publisher, year, edition, pages
Oxford University Press, 2023. Vol. 192, no 1, p. 41-50
Keywords [en]
home care, care homes, osteoporosis, hip fracture, ageing, registers, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Epidemiology; Population studies
Identifiers
URN: urn:nbn:se:umu:diva-198726DOI: 10.1093/aje/kwac149ISI: 000865704600001PubMedID: 35968686OAI: oai:DiVA.org:umu-198726DiVA, id: diva2:1688977
Funder
The Kamprad Family Foundation, 2019135Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-07115Available from: 2022-08-20 Created: 2022-08-20 Last updated: 2023-01-11Bibliographically approved

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Sandström, Glenn

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