A randomised controlled trial of a care home rehabilitation service to reduce long-term institutionalisation for elderly people

Fleming, Sarah A. and Blake, Holly and Gladman, John R.F. and Hart, Elizabeth and Lymbery, Mark and Dewey, Michael E. and McCloughry, Helen and Walker, Marion F. and Miller, Paul (2004) A randomised controlled trial of a care home rehabilitation service to reduce long-term institutionalisation for elderly people. Age and Ageing, 33 (4). pp. 384-390. ISSN 1468-2834

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Abstract

Objectives: to evaluate the effect of a care home rehabilitation service on institutionalisation, health outcomes and service use.

Design: randomised controlled trial, stratified by Barthel ADL index, social service sector and whether living alone. The intervention was a rehabilitation service based in Social Services old people's homes in Nottingham, UK. The control group received usual health and social care.

Participants: 165 elderly and disabled hospitalised patients who wished to go home but were at high risk of institutionalisation (81 intervention, 84 control).

Main outcome measures: institutionalisation rates, Barthel ADL index, Nottingham Extended ADL score, General Health Questionnaire (12 item version) at 3 and 12 months, Health and Social Service resource use.

Results: the number of participants institutionalised was similar at 3 months (relative risk 1.04, 95% confidence intervals 0.65–1.65) and 12 months (relative risk 1.23, 95% confidence intervals 0.75–2.02). Barthel ADL Index, Nottingham Extended ADL score and General Health Questionnaire scores were similar at 3 and 12 months. The intervention group spent significantly fewer days in hospital over 3 and 12 months (mean reduction 12.1 and 27.6 days respectively, P < 0.01), but spent a mean of 36 days in a care home rehabilitation service facility.

Conclusions: this service did not reduce institutionalisation, but diverted patients from the hospital to social services sector without major effects on activity levels or well-being.

Item Type: Article
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Age and Ageing following peer review. The version of record A randomised controlled trial of a care home rehabilitation service to reduce long-term institutionalisation for elderly people / Sarah A. Fleming , Holly Blake, John R.F. Gladman, Elizabeth Hart, Mark Lymbery, Michael E. Dewey, Helen McCloughry, Marion Walker and Paul Miller is available online at: http://ageing.oxfordjournals.org/content/33/4/384
Keywords: health services for the aged, rehabilitation, care homes, randomised controlled trial, elderly
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Rehabilitation and Ageing
Identification Number: https://doi.org/10.1093/ageing/afh126
Depositing User: Eprints, Support
Date Deposited: 13 Dec 2016 10:37
Last Modified: 13 Dec 2016 14:19
URI: http://eprints.nottingham.ac.uk/id/eprint/39345

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