Objective To evaluate the effect of intensive geriatric rehabilitation on demented patients with hip fracture. Design Preplanned subanalysis of randomised intervention study. Settting Jyväskylä Central Hospital, Finland. Participants 243 independently living patients aged 65 years or older admitted to hospital with hip fracture. Intervention After surgery patients in the intervention group (n = 120) were referred to the geriatric ward whereas those in the control group were discharged to local hospitals. Main outcome measures Length of hospital stay, mortality, and place of residence three months and one year after surgery for hip fracture. Results The median length of hospital stay of hip fracture patients with moderate dementia (mini mental state examination score 12-17) was 47 days in the intervention group (n = 24) and 147 days in the control group (n = 12, P = 0.04). The corresponding figures for patients with mild dementia (score 18-23) were 29 days in the intervention group (n = 35) and 46.5 days in the control group (n = 42, P = 0.002). Three months after the operation, in the intervention group 91% (32) of the patients with mild dementia and 63% (15) of the patients with moderate dementia were living independently. In the control group, the corresponding figures were 67% (28) and 17% (2). There were no significant differences in mortality or in the lengths of hospital stay of severely demented patients and patients with normal mini mental state examination scores. Conclusions Hip fracture patients with mild or moderate dementia can often return to the community if they are provided with active geriatric rehabilitation.

Objectives-To evaluate the impact of rheumatoid arthritis (RA) on the incidence of hip fractures. Methods-All patients with acute hip fractures admitted to Jyväskylä Central Hospital in 1991-93 (n=517) were selected from the hospital discharge register.

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Introduction . This article in the supplement on the PERFormance, Effectiveness, and Costs of Treatment episodes (PERFECT)-project aims to measure the performance and quality of hip fracture treatment by analysing annual trends and regional differences in developed performance indicators. Material and methods . The PERFECT Hip Fracture Database contains all hip fracture patients identifi ed from the Hospital Discharge Register in Finland since 1999. Follow-up data from several administrative registers were also linked to the database. Several risk-adjusted performance indicators were developed. Results. In 2007 (compared with 1999), 4.1 percentage points fewer patients had died and 7.5 percentage points more patients were at home four months after fracture. The mean length of treatment had shortened from about 50 to about 45 days, and the mean costs of treatment per patient during the year following hip fracture had increased from about € 18,000 to almost € 20,000. There was extensive variation between the hospitals in the proportion of patients with an operative delay longer than two days and clear differences between hospital districts in several performance indicators. Conclusions. Outcomes of hip fracture treatment in Finland have been improved in recent years, but regional variation exists. Register-based data are useful for performance assessment of hip fracture treatment.