Predictors of high caregiver burden after hospital discharge in caregivers of older adults with hip fracture: a retrospective cohort study

Abstract

Older adults with hip fracture place considerable physical and emotional strain on family caregivers, particularly during the early post-discharge period. This study aims to identify predictors of high caregiver burden within the first two weeks after hospital discharge among older adults with hip fracture. A retrospective observational cohort study was conducted in caregivers of older adults with hip fracture after hospital discharge at a university-affiliated tertiary care hospital in Thailand between November 2020 and September 2024. Caregiver burden score was assessed using the Short Zarit Burden Interview (ZBI-12), administered two weeks after hospital discharge with scores categorized into low and high burden using a cut-off of ≥ 13. The data included caregiver-related and patient-related data collected during hospitalization before discharge. Multivariable logistic regression identified predictive factors. A total of 185 caregivers of older adults with hip fracture were included; 64.86% were female with a mean age of 58.31 ± 13.34 years ( n = 176). Two weeks after discharge, 37 caregivers (20%) reported high caregiver burden. High caregiver burden was associated with financial problems (mOR = 13.21, 95% CI: 3.96–43.99; P < 0.001), older patient age (mOR = 1.06, 95% CI: 1.01–1.12; P = 0.023) and patients’ inability to ambulate with a walker before discharge (mOR = 3.03, 95% CI: 1.32–6.98; P = 0.009). Caregiver burden is an important concern in the early post-discharge period after hip fracture. Early identification of at-risk caregivers and incorporation of caregiver-focused assessments into discharge planning may facilitate targeted support, improve transitional care, and reduce adverse outcomes for both patients and caregivers.