Home versus day rehabilitation: a randomised controlled trial.
OBJECTIVE
to assess the effect of home versus day rehabilitation on patient outcomes.


METHODS
randomised controlled trial.


METHODS
post-hospital rehabilitation.


METHODS
two hundred and twenty-nine hospitalised patients referred for ambulatory rehabilitation.


METHODS
hospital-based day rehabilitation programme versus home-based rehabilitation programme.


METHODS
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.
Crotty
Maria
M
Flinders University Department of Rehabilitation and Aged Care, Adelaide SA 5001, Australia. maria.crotty@rgh.sa.gov.au
Giles
Lynne C
LC
Halbert
Julie
J
Harding
Julie
J
Miller
Michelle
M
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003631:Day Care, Medical / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006299:Health Services for the Aged / Q000592:standards / Q000706:statistics & numerical data; D006699:Home Care Services / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000534:rehabilitation; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission; D011787:Quality of Health Care / Q000592:standards / Q000706:statistics & numerical data; D011788:Quality of Life; D012047:Rehabilitation Centers / Q000592:standards* / Q000706:statistics & numerical data; D000071939:Stroke Rehabilitation; D006113:United Kingdom