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Home versus day rehabilitation: a randomised controlled trial

Publisher: 
Age and Ageing
Author: 
Maria Crotty, Lynne C. Giles, Julie Halbert, Julie Harding and Michelle Miller
Date published: 
28 August, 2008
Region: 
International

Publication type: 
research

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.

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