title: A study protocol of a randomised controlled trial incorporating a health economic analysis to investigate if additional allied health services for rehabilitation reduce length of stay without compromising patient outcomes.
abstract: BACKGROUND
  Reducing patient length of stay is a high priority for health service providers. Preliminary information suggests additional Saturday rehabilitation services could reduce the time a patient stays in hospital by three days. This large trial will examine if providing additional physiotherapy and occupational therapy services on a Saturday reduces health care costs, and improves the health of hospital inpatients receiving rehabilitation compared to the usual Monday to Friday service. We will also investigate the cost effectiveness and patient outcomes of such a service.
  
  
  METHODS
  A randomised controlled trial will evaluate the effect of providing additional physiotherapy and occupational therapy for rehabilitation. Seven hundred and twelve patients receiving inpatient rehabilitation at two metropolitan sites will be randomly allocated to the intervention group or control group. The control group will receive usual care physiotherapy and occupational therapy from Monday to Friday while the intervention group will receive the same amount of rehabilitation as the control group Monday to Friday plus a full physiotherapy and occupational therapy service on Saturday. The primary outcomes will be patient length of stay, quality of life (EuroQol questionnaire), the Functional Independence Measure (FIM), and health utilization and cost data. Secondary outcomes will assess clinical outcomes relevant to the goals of therapy: the 10 metre walk test, the timed up and go test, the Personal Care Participation Assessment and Resource Tool (PC PART), and the modified motor assessment scale. Blinded assessors will assess outcomes at admission and discharge, and follow up data on quality of life, function and health care costs will be collected at 6 and 12 months after discharge. Between group differences will be analysed with analysis of covariance using baseline measures as the covariate. A health economic analysis will be carried out alongside the randomised controlled trial.
  
  
  CONCLUSIONS
  This paper outlines the study protocol for the first fully powered randomised controlled trial incorporating a health economic analysis to establish if additional Saturday allied health services for rehabilitation inpatients reduces length of stay without compromising discharge outcomes. If successful, this trial will have substantial health benefits for the patients and for organizations delivering rehabilitation services.
  
  
  BACKGROUND
  Australian and New Zealand Clinical Trials Registry ACTRN12609000973213.
authors.affiliation: Eastern Health, 5 Arnold Street, Box Hill, Victoria, 3128, Australia. N.Taylor@latrobe.edu.au
authors.forename: Nicholas F
authors.initials: NF
authors.lastname: Taylor
authors.forename: Natasha K
authors.initials: NK
authors.lastname: Brusco
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Watts
authors.forename: Nora
authors.initials: N
authors.lastname: Shields
authors.forename: Casey
authors.initials: C
authors.lastname: Peiris
authors.forename: Natalie
authors.initials: N
authors.lastname: Sullivan
authors.forename: Genevieve
authors.initials: G
authors.lastname: Kennedy
authors.forename: Cheng Kwong
authors.initials: CK
authors.lastname: Teo
authors.forename: Allison
authors.initials: A
authors.lastname: Farley
authors.forename: Kylee
authors.initials: K
authors.lastname: Lockwood
authors.forename: Camilla
authors.initials: C
authors.lastname: Radia-George
mesh_terms: D000328:Adult; D000368:Aged; D000488:Allied Health Personnel / Q000600:supply & distribution*; D000704:Analysis of Variance; D016001:Confidence Intervals; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D009788:Occupational Therapy / Q000379:methods*; D026741:Physical Therapy Modalities; D012046:Rehabilitation / Q000458:organization & administration*; D012047:Rehabilitation Centers; D018570:Risk Assessment; D016037:Single-Blind Method; D013997:Time Factors; D017749:Total Quality Management; D016896:Treatment Outcome; D055815:Young Adult