Postacute Care for Older People in Community Hospitals: A Multicenter Randomized, Controlled Trial

J Am Geriatr Soc. 2007 Dec;55(12):1995-2002. doi: 10.1111/j.1532-5415.2007.01456.x. Epub 2007 Nov 2.

Abstract

Objectives: To compare the effects of community hospital care on independence for older people needing rehabilitation with that of general hospital care.

Design: Randomized, controlled trial.

Setting: Seven community hospitals and five general hospitals in the midlands and north of England.

Participants: Four hundred ninety patients needing rehabilitation after hospital admission with an acute illness.

Intervention: Multidisciplinary team care for older people in community hospitals.

Measurements: The primary outcome was the Nottingham extended activities of daily living scale (NEADL); secondary outcomes were the Barthel Index, Nottingham Health Profile, Hospital Anxiety and Depression Scale, mortality, discharge destination, 6-month residence status, and satisfaction with services.

Results: Loss of independence at 6 months was significantly less likely in the community hospital group (mean adjusted NEADL change score group difference 3.27; 95% confidence interval 0.26-6.28; P=.03). The results for the secondary outcome measures were similar for the two groups.

Conclusion: Postacute community hospital rehabilitation care for older people is associated with greater independence.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Analysis of Variance
  • Chi-Square Distribution
  • England
  • Female
  • Hospitals, Community / organization & administration*
  • Humans
  • Male
  • Prospective Studies
  • Statistics, Nonparametric
  • Subacute Care / organization & administration*
  • Treatment Outcome