Grant: Project Grant

Older people frequently require surgeries, like joint replacement for arthritis, bowel surgery for cancer or vascular surgery to treat blood vessel diseases. When thinking about having surgery, older people have clearly said that one of their top priorities is getting home after their operation. Unfortunately, 15% to 50% of older people who have surgery do not go directly home afterward. Making a decision to have surgery is especially hard for older people because they don't have sound information about how likely they are to get back home. Our team reviewed all data about being discharged home that can be used to help older people, and the data are badly flawed. Researchers have combined very different outcomes (death or going to a rehabilitation center) into a single measure. Researchers have also failed to acknowledge how long people are in hospital before they go home. While researchers have tried to help patients to understand their personal chances of getting home or not, the combination of poor definitions of what it means not to go home, not accounting for time in hospital and poor research methods to build tools to forecast people's outcomes means that older people are unable to access accurate and relevant information to help them decide about surgery. To help older people considering surgery, we will do a study in ON, MB & BC using a definition of where, when and how people leave hospital that was created in partnership with older people who've had surgery before. Using this sensible definition, we will describe for older Canadians how common it is to be home 3 months after surgery, compared to dead, still in-hospital, in a nursing home or a rehabilitation center. We will also create tools to show older Canadians for each week after surgery how likely someone like them would be to be in any one of these different locations. We plan to conduct future research to learn how these tools can help older people to make their best decision about having surgery.