Crotty M, Giles LC, Halbert J, Harding J, Miller M. Home versus day rehabilitation: a randomised controlled trial.
Age Ageing 2008;
37:628-33. [PMID:
18723862 PMCID:
PMC2582455 DOI:
10.1093/ageing/afn141]
[Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2007] [Accepted: 04/16/2008] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE
to assess the effect of home versus day rehabilitation on patient outcomes.
DESIGN
randomised controlled trial.
SETTING
post-hospital rehabilitation.
PARTICIPANTS
two hundred and twenty-nine hospitalised patients referred for ambulatory rehabilitation.
INTERVENTIONS
hospital-based day rehabilitation programme versus home-based rehabilitation programme.
MAIN OUTCOME MEASURES
at 3 months, information was collected on hospital readmission, transfer to residential care, functional level, quality of life, carer stress and carer quality of life. At 6 months, place of residence, hospital re-admissions and mortality status were collected.
RESULTS
there were significant improvements in the functional outcomes from baseline to 3 months for all participants. At discharge, carers of patients in day hospital reported higher Caregiver Strain Index (CSI) scores in comparison to home rehabilitation carers (4.95 versus 3.56, P = 0.047). Patients in day hospital had double the risk of readmission compared to those in home rehabilitation (RR = 2.1; 95% CI 1.2-3.9). This effect persisted at 6 months.
CONCLUSIONS
day hospital patients are more likely to be readmitted to hospital possibly due to increased access to admitting medical staff. This small trial favours the home as a better site for post-hospital rehabilitation.
Collapse