Characteristics of rehabilitation services in high-FIM efficiency hospitals after hip fracture

Characteristics of rehabilitation services probably explain a large proportion of the variation in clinical outcomes following hip fracture. The aim of this study was to clarify rehabilitation characteristics of high-performance hospitals after hip fracture. This is a retrospective observational study using the Japan Rehabilitation Database for the period 2005–2015. We divided facilities into high-FIM efficiency and low-FIM efficiency hospitals by using the mean of Functional Independence Measure efficiency for each hospital. We compared rehabilitation characteristics between high- and low-FIM efficiency hospitals. We identified 1247 patients with hip fracture from 12 hospitals who were eligible for analysis after applying exclusion criteria. Using one-to-one random matching on admission Functional Independence Measure, 880 pairs of patients were included for final analysis. More patients were discharged home in the high-FIM efficiency hospitals compared with low-FIM efficiency hospitals. High-FIM efficiency hospitals had significantly shorter length of stay. Patients in high-FIM efficiency hospitals received higher amounts of daily rehabilitation, early rehabilitation, and preoperative rehabilitation. Patients in high-FIM efficiency hospitals engaged in more weekend exercise and self-exercise. Our data suggested that the amount, timing, and type of rehabilitation are essential indicators of performance in acute hip fracture.