title: Rehabilitation of older patients: day hospital compared with rehabilitation at home. Clinical outcomes.
abstract: OBJECTIVE
  to test the hypothesis that older people and their informal carers are not disadvantaged by home-based rehabilitation (HBR) relative to day hospital rehabilitation (DHR).
  
  
  METHODS
  pragmatic randomised controlled trial.
  
  
  METHODS
  four geriatric day hospitals and four home rehabilitation teams in England.
  
  
  METHODS
  eighty-nine patients referred for multidisciplinary rehabilitation. The target sample size was 460.
  
  
  METHODS
  multidisciplinary rehabilitation either in the home or in the day hospital.
  
  
  METHODS
  the primary outcome measure was the Nottingham extended activities of daily living scale (NEADL). Secondary outcome measures included EQ-5D, hospital anxiety and depression scale, therapy outcome measures, hospital admissions and the General Health Questionnaire for carers.
  
  
  RESULTS
  at the primary end point of 6 months NEADL scores were not significantly in favour of HBR cf. DHR; mean difference -2.139 (95% confidence interval -6.87 to 2.59, P = 0.37). A post hoc analysis suggested non-inferiority for HBR for NEADL but there was considerable statistical uncertainty.
  
  
  CONCLUSIONS
  taken together the statistical analyses and lack of power of the trial outcomes do not provide sufficient evidence to conclude that patients in receipt of HBR are disadvantaged compared with those receiving DHR.
authors.affiliation: Sheffield Institute for Studies on Ageing, University of Sheffield, Samuel Fox House, Northern General Hospital, Sheffield S5 7AU, UK. s.g.parker@sheffield.ac.uk
authors.forename: Stuart G
authors.initials: SG
authors.lastname: Parker
authors.forename: Phillip
authors.initials: P
authors.lastname: Oliver
authors.forename: Mark
authors.initials: M
authors.lastname: Pennington
authors.forename: John
authors.initials: J
authors.lastname: Bond
authors.forename: Carol
authors.initials: C
authors.lastname: Jagger
authors.forename: Pam
authors.initials: P
authors.lastname: Enderby
authors.forename: Richard
authors.initials: R
authors.lastname: Curless
authors.forename: Alessandra
authors.initials: A
authors.lastname: Vanoli
authors.forename: Kate
authors.initials: K
authors.lastname: Fryer
authors.forename: Steven
authors.initials: S
authors.lastname: Julious
authors.forename: Alexandra
authors.initials: A
authors.lastname: John
authors.forename: T
authors.initials: T
authors.lastname: Chater
authors.forename: Cindy
authors.initials: C
authors.lastname: Cooper
authors.forename: Chris
authors.initials: C
authors.lastname: Dyer
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001007:Anxiety / Q000209:etiology; D017028:Caregivers; D003631:Day Care, Medical; D003863:Depression / Q000209:etiology; D004739:England; D006299:Health Services for the Aged; D006699:Home Care Services; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010348:Patient Care Team; D012046:Rehabilitation; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome