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March 11, 1983

Institutionalization of Patients With Hip Fractures

Author Affiliations

George Washington University Medical Center Washington, DC
Washington, DC

JAMA. 1983;249(10):1269. doi:10.1001/jama.1983.03330340019021

To the Editor.—  "Hip Fractures in the Elderly" (1982;248:564) brings to light an important issue related to the medical reason for nursing home placement. It is largely an unexplored area, despite the fact that it is the physician who ultimately makes the application for institutionalization. The high percentage of patients with hip fractures who were institutionalized in this study, 41%, is surprising and alarming. At any particular time, there is only a small population of patients with hip fractures residing in nursing homes: 8.3% of the total nursing home population in 1977 had hip fractures.1 The above data suggest that the decision of institutionalization made after discharge from this particular hospital was not made appropriately. It is possible that the functional scale used in the study would be more appropriately used in the decision-making process for institutionalization v discharge to the community.The patients who were predicted to be