Poster Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2025

Survey of early supported discharge programs (ESDP) for low-trauma hip fracture patients in Australian public hospitals (120268)

Robert A Devereux 1 , Justine Naylor 1 , Danielle Ní Chróinín 2 , Thuy Bui 1 , Serena Hong 3 , Jacqueline Close 4 , Jamie Hallen 4 , Christopher Wall 4
  1. School of Clinical Medicine, The University of New South Wales, Sydney, NSW, Australia
  2. Orthopaedic Department, Liverpool Hospital, Sydney, NSW, 2170
  3. School of Health Sciences, UNSW, Sydney, NSW, Australia
  4. Australian & New Zealand Hip Fracture Registry, Neuroscience Research Australia, Sydney, NSW, Australia

Aims:
To investigate the prevalence and characteristics of ESDP for low-trauma hip fracture patients.

Methods:
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 in the Australian and New Zealand Hip Fracture Registry (ANZHFR) (90% national coverage).

Results:
Amongst 35 hospitals (response rate 43 %), 66% (23/35) reported providing Hospital in the Home (HITH) or Rehabilitation in the Home (RITH) programs, though none were specific to hip fracture. Hospitals offering these programs reported shorter acute (LOS) compared to those without (9.41 versus 11.33 days, p=.038 ). Where ≤30% of patients came from culturally and linguistically diverse backgrounds (CALD) the use of HITH/RITH services was 71% (10/14) compared with 50% (6/12) where CALD was >30%. Where ≤25% of patients were from non-English speaking background (NESB) and required a translator, the use of HITH/RITH services was 74% (14/19) compared with 57% (4/7) where NESB was >25%.
There was variability in program staffing with physiotherapists (87%, 33/38), occupational therapists (84%, 32/38), and nurses (82%, 31/38) being the most frequently required. The most common eligibility criterion was living in a geographical area covered by the program (92%, 35/38).

Conclusions:
The study highlights variability in ESDPs and identifies possible gaps in service provision particularly in hospitals with higher proportions of CALD and NESB patients. The unadjusted reduced acute LOS associated with ESDP suggests potential benefits in alleviating hospital congestion.