{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T18:06:28Z","timestamp":1788717988881,"version":"build-2803163510"},"reference-count":24,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T00:00:00Z","timestamp":1672272000000},"content-version":"unspecified","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Bruy\u00e8re Academic Medical Organization","award":["BAM-22-001"],"award-info":[{"award-number":["BAM-22-001"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,11,23]]},"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Hip fracture patients receive varying levels of support posthip fracture surgery and often experience significant disability and increased risk of mortality. Best practice guidelines recommend that all hip fracture patients receive active rehabilitation following their acute care stay, with rehabilitation beginning no later than 6\u2009days following surgery. Nevertheless, patients frequently experience gaps in care including delays and variation in rehabilitation services they receive. We aim to understand the factors that drive these practice variations for older adults following hip fracture surgery, and their impact on patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We will conduct a retrospective population-based cohort study using routinely collected health administrative data housed at ICES. The study population will include all individuals with a unilateral hip fracture aged 50 and older who underwent surgical repair in Ontario, Canada between 1 January 2015 and 31 December 2018. We will use unadjusted and multilevel, multivariable adjusted regression models to identify predictors of rehabilitation setting, time to rehabilitation and length of rehabilitation, with predictors prespecified including patient sociodemographics, baseline health and characteristics of the acute (surgical) episode. We will examine outcomes after rehabilitation, including place of care\/residence at 6 and 12\u2009months postrehabilitation, as well as other short-term and long-term outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The use of the data in this project is authorised under section 45 of Ontario\u2019s Personal Health Information Protection Act and does not require review by a Research Ethics Board. Results will be disseminated through conference presentations and in peer-reviewed journals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-065599","type":"journal-article","created":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T13:03:17Z","timestamp":1672318997000},"page":"e065599","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Postsurgery paths and outcomes for hip fracture patients (POST-OP HIP PATHS): a population-based retrospective cohort study protocol"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7431-8159","authenticated-orcid":false,"given":"Chantal","family":"Backman","sequence":"first","affiliation":[{"name":"School of Nursing, University of Ottawa, Ottawa, Ontario, Canada"},{"name":"Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada"},{"name":"Bruy\u00e8re Research Institute, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soha","family":"Shah","sequence":"additional","affiliation":[{"name":"Care of the Elderly, Bruy\u00e8re Continuing Care, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9193-5386","authenticated-orcid":false,"given":"Colleen","family":"Webber","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada"},{"name":"Bruy\u00e8re Research Institute, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Turcotte","sequence":"additional","affiliation":[{"name":"University of Waterloo, Waterloo, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D I","family":"McIsaac","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada"},{"name":"University of Ottawa Department of Anesthesiology, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Papp","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, Ottawa Hospital, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Harley","sequence":"additional","affiliation":[{"name":"Care of the Elderly, Bruy\u00e8re Continuing Care, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Beaul\u00e9","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, Ottawa Hospital, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00e9ronique","family":"French-Merkley","sequence":"additional","affiliation":[{"name":"Care of the Elderly, Bruy\u00e8re Continuing Care, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randa","family":"Berdusco","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, Ottawa Hospital, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephane","family":"Poitras","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Tanuseputro","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada"},{"name":"Bruy\u00e8re Research Institute, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,12,29]]},"reference":[{"key":"2025121604594511000_12.12.e065599.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2018.04.015"},{"key":"2025121604594511000_12.12.e065599.2","doi-asserted-by":"publisher","DOI":"10.1007\/PL00004148"},{"key":"2025121604594511000_12.12.e065599.3","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v10.i3.166"},{"key":"2025121604594511000_12.12.e065599.4","unstructured":"Health Quality Ontario . Quality Standards. hip fracture care for people with fragility fractures. Toronto, ON: health quality Ontario, 2017. Available: https:\/\/www.hqontario.ca\/portals\/0\/documents\/evidence\/quality-standards\/qs-hip-fracture-clinical-guide-en.pdf"},{"key":"2025121604594511000_12.12.e065599.5","unstructured":"Health Quality Ontario & Ministry of Health and Long-Term Care . Quality-Based procedures: clinical Handbook for hip fracture. Toronto, on: health quality Ontario, 2013. Available: https:\/\/www.health.gov.on.ca\/en\/pro\/programs\/ecfa\/docs\/qbp_hipfracture.pdf"},{"key":"2025121604594511000_12.12.e065599.6","doi-asserted-by":"crossref","first-page":"215145932093510","DOI":"10.1177\/2151459320935100","article-title":"Postacute management of older adults suffering an osteoporotic hip fracture: a consensus statement from the International geriatric fracture Society","volume":"11","author":"Reyes","year":"2020","journal-title":"Geriatr Orthop Surg Rehabil"},{"key":"2025121604594511000_12.12.e065599.7","unstructured":"National Institute for Health and Care Excellence . Hip fracture overview, 2020. Available: http:\/\/pathways.nice.org.uk\/pathways\/hip-fracture"},{"key":"2025121604594511000_12.12.e065599.8","unstructured":"American Academy of orthopaedic surgeons. management of hip fractures in the elderly, 2015. Available: https:\/\/www.orthoguidelines.org\/go\/auc\/default.cfm?auc_id=224956&actionxm=Terms"},{"key":"2025121604594511000_12.12.e065599.9","unstructured":"Rehabilitative Care Alliance . Rehabilitative care best practices for patients with hip fracture, 2018."},{"key":"2025121604594511000_12.12.e065599.10","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.jamda.2019.01.147","article-title":"A framework for supporting post-acute care transitions of older patients with hip fracture","volume":"20","author":"Stolee","year":"2019","journal-title":"J Am Med Dir Assoc"},{"key":"2025121604594511000_12.12.e065599.11","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-016-1524-1"},{"key":"2025121604594511000_12.12.e065599.12","doi-asserted-by":"crossref","DOI":"10.1007\/s11657-017-0382-8","article-title":"Discharge destination following hip fracture: comparative effectiveness and cost analyses","volume":"12","author":"Pitzul","year":"2017","journal-title":"Arch Osteoporos"},{"key":"2025121604594511000_12.12.e065599.13","unstructured":"Alberta health services BJH SCN post-acute care of hip fracture. optimizing the post-acute continuum of care following a hip fracture white paper, 2019. Available: https:\/\/www.albertahealthservices.ca\/assets\/about\/scn\/ahs-scn-bjh-hip-white-paper.pdf"},{"key":"2025121604594511000_12.12.e065599.14","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1111\/1475-6773.13739","article-title":"Differences in health care spending and utilization among older frail adults in high-income countries: ICCONIC hip fracture persona","volume":"56 Suppl 3","author":"Papanicolas","year":"2021","journal-title":"Health Serv Res"},{"key":"2025121604594511000_12.12.e065599.15","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1111\/1475-6773.13734","article-title":"International comparison of spending and utilization at the end of life for hip fracture patients","volume":"56 Suppl 3","author":"Blankart","year":"2021","journal-title":"Health Serv Res"},{"key":"2025121604594511000_12.12.e065599.16","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1111\/1475-6773.13864","article-title":"An international comparison of long-term care trajectories and spending following hip fracture","volume":"56 Suppl 3","author":"Wodchis","year":"2021","journal-title":"Health Serv Res"},{"key":"2025121604594511000_12.12.e065599.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.014"},{"key":"2025121604594511000_12.12.e065599.18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001885"},{"key":"2025121604594511000_12.12.e065599.19","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2018.0049"},{"key":"2025121604594511000_12.12.e065599.20","article-title":"Days alive and at home after hip fracture: a cross-sectional validation of a patient-centred outcome measure using routinely collected data","author":"McIsaac","year":"2021","journal-title":"BMJ Qual Saf"},{"key":"2025121604594511000_12.12.e065599.21","doi-asserted-by":"crossref","first-page":"182-188","DOI":"10.1503\/cmaj.150064","article-title":"A 3-year study of high-cost users of health care","volume":"188","author":"Wodchis","year":"2016","journal-title":"CMAJ"},{"key":"2025121604594511000_12.12.e065599.22","doi-asserted-by":"crossref","first-page":"2619","DOI":"10.1007\/s11136-016-1281-y","article-title":"The relative impact of chronic conditions and multimorbidity on health-related quality of life in Ontario long-stay home care clients","volume":"25","author":"Mondor","year":"2016","journal-title":"Qual Life Res"},{"key":"2025121604594511000_12.12.e065599.23","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002769"},{"key":"2025121604594511000_12.12.e065599.24","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2018-008852"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2022-065599","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:59:58Z","timestamp":1765889998000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2022-065599"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":24,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12,29]]},"published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1136\/bmjopen-2022-065599"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2022-065599","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12]]}}}