title: Rehabilitation outcomes of older patients at 6 months follow-up after discharged from a geriatric day hospital (GDH).
abstract: Whether rehabilitation outcome can be maintained after discharged from GDH has not been thoroughly investigated. This study was conducted to examine the rehabilitation outcome and its predictors 6 months after discharged from GDH. We studied 418 patients attended a GDH in Hong Kong. All of them had post-6-month assessment. Cognitive status was assessed with Cantonese version of mini-mental state examination (C-MMSE). Functional independence measure (FIM) upon GDH admission (FIM-adm), discharge (FIM-dis) and 6 months after discharge (FIM-p6m) were measured. FIM gain was FIM-dis-FIM-adm while FIM efficiency was FIM gain divided by number of GDH visits. Of the study pool, 164 (39.2%) showed a drop of FIM-p6m. There was a significant drop of FIM-p6m as compared with FIM-dis (p<0.001). However, the FIM-p6m remained significantly higher than FIM-adm (p<0.001). Multivariate analysis revealed that FIM-dis was a negative predictor (p<0.001) while Parkinsonism was a positive predictor for drop of FIM-p6m (p=0.008). A proportion of functional gain can still be maintained 6 months after discharged from GDH. More studies are needed to look for strategies in maintaining functional gain in GDH discharged patients, especially those with Parkinsonism.
authors.affiliation: The University of Hong Kong Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Pokfulam Road, Hong Kong SAR, China. lukkh@ha.org.hk
authors.forename: James Ka Hay
authors.initials: JK
authors.lastname: Luk
authors.forename: Charles Fei
authors.initials: CF
authors.lastname: Chan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D003072:Cognition Disorders / Q000534:rehabilitation; D003631:Day Care, Medical; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006299:Health Services for the Aged; D006620:Hip Fractures / Q000534:rehabilitation; D006761:Hospitals; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000534:rehabilitation; D010351:Patient Discharge; D012189:Retrospective Studies; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome