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Age and Ageing Advance Access published online on August 23, 2008
Age and Ageing, doi:10.1093/ageing/afn141
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Copyright © The Author 2008. Published by Oxford University Press on behalf of the British Geriatrics Society.
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org

Home versus day rehabilitation: a randomised controlled trial

Maria Crotty1, Lynne C. Giles1, Julie Halbert1, Julie Harding2 and Michelle Miller3

1 Flinders University Department of Rehabilitation and Aged Care, Adelaide SA 5001, Australia
2 Department of Rehabilitation and Aged Care, Repatriation General Hospital, Daw Park SA 5041, Australia
3 Flinders University Department of Nutrition and Dietetics, Adelaide SA 5001, Australia

Address correspondence to: M. Crotty. Tel: +61 8 8275 1643; Fax: +61 8 8275 1130. Email: maria.crotty{at}rgh.sa.gov.au

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.

Keywords: ambulatory rehabilitation, day rehabilitation, home rehabilitation, randomised controlled trial, elderly

Received 23 November 2007; accepted in revised form 16 April 2008.


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