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

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 ba...

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Main Authors: Fleming, Sarah A., Blake, Holly, Gladman, John R.F., Hart, Elizabeth, Lymbery, Mark, Dewey, Michael E., McCloughry, Helen, Walker, Marion F., Miller, Paul
Format: Article
Published: Oxford University Press 2004
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Online Access:https://eprints.nottingham.ac.uk/39345/
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author Fleming, Sarah A.
Blake, Holly
Gladman, John R.F.
Hart, Elizabeth
Lymbery, Mark
Dewey, Michael E.
McCloughry, Helen
Walker, Marion F.
Miller, Paul
author_facet Fleming, Sarah A.
Blake, Holly
Gladman, John R.F.
Hart, Elizabeth
Lymbery, Mark
Dewey, Michael E.
McCloughry, Helen
Walker, Marion F.
Miller, Paul
author_sort Fleming, Sarah A.
building Nottingham Research Data Repository
collection Online Access
description 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.
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spelling nottingham-393452020-05-04T16:25:53Z https://eprints.nottingham.ac.uk/39345/ A randomised controlled trial of a care home rehabilitation service to reduce long-term institutionalisation for elderly people Fleming, Sarah A. Blake, Holly Gladman, John R.F. Hart, Elizabeth Lymbery, Mark Dewey, Michael E. McCloughry, Helen Walker, Marion F. Miller, Paul 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. Oxford University Press 2004-05-19 Article PeerReviewed Fleming, Sarah A., Blake, Holly, Gladman, John R.F., Hart, Elizabeth, Lymbery, Mark, Dewey, Michael E., McCloughry, Helen, 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 health services for the aged rehabilitation care homes randomised controlled trial elderly http://ageing.oxfordjournals.org/content/33/4/384 doi:10.1093/ageing/afh126 doi:10.1093/ageing/afh126
spellingShingle health services for the aged
rehabilitation
care homes
randomised controlled trial
elderly
Fleming, Sarah A.
Blake, Holly
Gladman, John R.F.
Hart, Elizabeth
Lymbery, Mark
Dewey, Michael E.
McCloughry, Helen
Walker, Marion F.
Miller, Paul
A randomised controlled trial of a care home rehabilitation service to reduce long-term institutionalisation for elderly people
title A randomised controlled trial of a care home rehabilitation service to reduce long-term institutionalisation for elderly people
title_full A randomised controlled trial of a care home rehabilitation service to reduce long-term institutionalisation for elderly people
title_fullStr A randomised controlled trial of a care home rehabilitation service to reduce long-term institutionalisation for elderly people
title_full_unstemmed A randomised controlled trial of a care home rehabilitation service to reduce long-term institutionalisation for elderly people
title_short A randomised controlled trial of a care home rehabilitation service to reduce long-term institutionalisation for elderly people
title_sort randomised controlled trial of a care home rehabilitation service to reduce long-term institutionalisation for elderly people
topic health services for the aged
rehabilitation
care homes
randomised controlled trial
elderly
url https://eprints.nottingham.ac.uk/39345/
https://eprints.nottingham.ac.uk/39345/
https://eprints.nottingham.ac.uk/39345/