Postacute care following stroke or hip fracture - Single services and combinations used by medicare beneficiaries (1987-1992)

Objective: To describe the use of postacute services alone or in combination following a hospitalization for a hip fracture or stroke by Medicare beneficiaries who were relatively well and living in the community prior to the index event. Methods: Health-service use histories were constructed using Medicare claims. Patients in the study represented all subjects from a 1% sample of Medicare beneficiaries who were age 70 years or older at the time of the index hospitalization. Results: From 1987 to 1992, the proportion of patients receiving any postacute care and those receiving combinations of care increased. For example, there was a doubling of the proportion of patients with either condition using sequences of rehabilitation with home health or SNF and home health. Within I year of the hospitalization, 42.6% of patients with stroke and 35.0% post-hip fracture had been rehospitalized. Discussion: Resource use and assessment of patient outcomes should be examined across the continuum of postacute care and in the months beyond to examine the relative effectiveness of different combinations of care.