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<i>Summary</i> <p>Post-discharge destination was associated with differences in osteoporosis medication use after hip fracture. Discharge to long-term care facilities or home with long-term care services was associated with lower medication use. Prior treatment history was associated with differences in subgroup-specific estimates among community-dwelling patients, although formal interaction testing was not statistically significant.</p> Background <p>Post-discharge destination may influence osteoporosis care after hip fracture, but evidence is limited.</p> Methods <p>Using the National Health Insurance Service–Senior cohort in South Korea, we identified patients aged ≥ 60&#xa0;years who underwent surgical treatment for incident hip fracture between 2005 and 2017. Post-discharge destination at 30&#xa0;days was categorized as home without LTC services, home with LTC services, hospital, or LTC facility. The primary outcome was any osteoporosis medication use within 1&#xa0;year after discharge from an acute-care hospital, defined as at least one prescription during follow-up. Incidence rates were calculated, and adjusted hazard ratios (aHRs) were estimated using Cox proportional hazards models, with stratified analyses according to prior osteoporosis medication use.</p> Results <p>Among 12,226 patients, osteoporosis medication use within 1&#xa0;year differed significantly by post-discharge destination. Compared with patients discharged home without LTC services, those discharged to LTC facilities (aHR, 0.61; 95% CI, 0.50–0.76) and home with LTC services (aHR, 0.84; 95% CI, 0.73–0.97) were associated with a lower hazard of receiving osteoporosis medication. In stratified analyses, discharge to LTC facilities was consistently associated with lower medication use across subgroups defined by prior treatment history. Among patients discharged home with LTC services, lower medication use was observed primarily among treatment-naïve patients, whereas this pattern was less apparent among those with prior medication use; however, formal interaction testing was not statistically significant.</p> Conclusions <p>Osteoporosis medication use after hip fracture was associated with differences according to post-discharge destination. Lower medication use was observed among patients discharged to LTC facilities and, to a lesser extent, among those receiving home-based LTC services. These findings should be interpreted with caution, as some of the lower use in LTC settings may reflect appropriate clinical decision-making in the context of competing care priorities or limited life expectancy.</p>

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Association between post-discharge destination and osteoporosis medication use after acute-care hospital discharge for hip fracture: a population-based cohort study

  • 期刊论文

  • 发表日期：

    2026年7月29日

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  • Seung Hoon Kim,
  • Eunjeong Choi,
  • Yonghan Cha,
  • Seoyeong Choi,
  • Suk-Yong Jang

摘要

Summary

Post-discharge destination was associated with differences in osteoporosis medication use after hip fracture. Discharge to long-term care facilities or home with long-term care services was associated with lower medication use. Prior treatment history was associated with differences in subgroup-specific estimates among community-dwelling patients, although formal interaction testing was not statistically significant.

Background

Post-discharge destination may influence osteoporosis care after hip fracture, but evidence is limited.

Methods

Using the National Health Insurance Service–Senior cohort in South Korea, we identified patients aged ≥ 60 years who underwent surgical treatment for incident hip fracture between 2005 and 2017. Post-discharge destination at 30 days was categorized as home without LTC services, home with LTC services, hospital, or LTC facility. The primary outcome was any osteoporosis medication use within 1 year after discharge from an acute-care hospital, defined as at least one prescription during follow-up. Incidence rates were calculated, and adjusted hazard ratios (aHRs) were estimated using Cox proportional hazards models, with stratified analyses according to prior osteoporosis medication use.

Results

Among 12,226 patients, osteoporosis medication use within 1 year differed significantly by post-discharge destination. Compared with patients discharged home without LTC services, those discharged to LTC facilities (aHR, 0.61; 95% CI, 0.50–0.76) and home with LTC services (aHR, 0.84; 95% CI, 0.73–0.97) were associated with a lower hazard of receiving osteoporosis medication. In stratified analyses, discharge to LTC facilities was consistently associated with lower medication use across subgroups defined by prior treatment history. Among patients discharged home with LTC services, lower medication use was observed primarily among treatment-naïve patients, whereas this pattern was less apparent among those with prior medication use; however, formal interaction testing was not statistically significant.

Conclusions

Osteoporosis medication use after hip fracture was associated with differences according to post-discharge destination. Lower medication use was observed among patients discharged to LTC facilities and, to a lesser extent, among those receiving home-based LTC services. These findings should be interpreted with caution, as some of the lower use in LTC settings may reflect appropriate clinical decision-making in the context of competing care priorities or limited life expectancy.