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Consumption versus need of institutional care after femoral neck fracture.

For 137 patients who sustained a femoral neck fracture domiciliary circumstances, ADL functional level and walking ability were recorded during a period of six months in 1983. At the time of injury 71% were living at home or in a so-called service apartment with medical and domestic facilities, and 28% in chronic care institutions (1% were transferred from other acute care units). Of the surviving patients 43% could return directly home or to a service apartment on discharge, 21% were transferred to an orthopedic rehabilitation facility, convalescent home, or other acute care unit, and 36% to chronic care institutions. At the 1-year as well as the 2-year follow-up 39% of the surviving patients were living in chronic care institutions. Analysis of the various parameters for patients having recourse to chronic care facilities at follow-up, showed that almost half of this group might be cared for at home. However, this will only be possible on condition that an extensive and effective home medical care system is developed as a complement to domestic assistance provided by public agencies. It is unrealistic to expect the incidence of patients needing chronic care facilities following femoral neck fracture to subside below a minimum of 20%.