Effects of locality based community hospital care on independence in older people needing rehabilitation: randomised controlled trial.
OBJECTIVE
To determine the effects on independence in older people needing rehabilitation in a locality based community hospital compared with care on a ward for elderly people in a district general hospital.


METHODS
Randomised controlled trial.


METHODS
Care in a community hospital and district general hospital in Bradford, England.


METHODS
220 patients needing rehabilitation after an acute illness that required hospital admission.


METHODS
Patients were randomly allocated to a locality based community hospital or to remain within a department for the care of elderly people in a district general hospital.


METHODS
Primary outcomes were Nottingham extended activities of daily living scale and general health questionnaire 28 (carer). Secondary outcomes were activities of daily living (Barthel index), Nottingham health profile, hospital anxiety and depression scale, mortality, destination after discharge, satisfaction with services, carer strain index, and carer's satisfaction with services.


RESULTS
The median length of stay was 15 days for both the community hospital and the district general hospital groups (interquartile range: community hospital 9-25 days; district general hospital 9-24 days). Independence at six months was greater in the community hospital group (adjusted mean difference 5.30, 95% confidence interval 0.64 to 9.96). Results for the secondary outcome measures, including care satisfaction and measures of carer burden, were similar for both groups.


CONCLUSIONS
Care in a locality based community hospital is associated with greater independence for older people than care in wards for elderly people in a district general hospital.
Green
John
J
Department of Health Care for the Elderly, St Luke's Hospital, Bradford BD5 0NA. becarrd.1@bradfordhospitals.nhs.uk
Young
John
J
Forster
Anne
A
Mallinder
Karen
K
Bogle
Sue
S
Lowson
Karin
K
Small
Neil
N
D000203:Activities of Daily Living; D000368:Aged; D004739:England; D005500:Follow-Up Studies; D006760:Hospitalization; D006764:Hospitals, Community / Q000458:organization & administration*; D006767:Hospitals, District / Q000458:organization & administration*; D006801:Humans; D007902:Length of Stay; D017060:Patient Satisfaction; D011379:Prognosis; D012046:Rehabilitation / Q000458:organization & administration*