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A randomised controlled trial of a care home rehabilitation service to reduce long-term institutionalisation for elderly people

Fleming, Sarah A.; Blake, Holly; Gladman, John R.F.; Hart, Elizabeth; Lymbery, Mark; Dewey, Michael E.; McCloughry, Helen; Walker, Marion F.; Miller, Paul

Authors

Sarah A. Fleming

JOHN GLADMAN john.gladman@nottingham.ac.uk
Professor of Medicine of Older People

Elizabeth Hart

Mark Lymbery

Michael E. Dewey

Helen McCloughry

Marion F. Walker

Paul Miller



Abstract

Objectives: to evaluate the effect of a care home rehabilitation service on institutionalisation, health outcomes and service use.

Design: randomised controlled trial, stratified by Barthel ADL index, social service sector and whether living alone. The intervention was a rehabilitation service based in Social Services old people's homes in Nottingham, UK. The control group received usual health and social care.

Participants: 165 elderly and disabled hospitalised patients who wished to go home but were at high risk of institutionalisation (81 intervention, 84 control).

Main outcome measures: institutionalisation rates, Barthel ADL index, Nottingham Extended ADL score, General Health Questionnaire (12 item version) at 3 and 12 months, Health and Social Service resource use.

Results: the number of participants institutionalised was similar at 3 months (relative risk 1.04, 95% confidence intervals 0.65–1.65) and 12 months (relative risk 1.23, 95% confidence intervals 0.75–2.02). Barthel ADL Index, Nottingham Extended ADL score and General Health Questionnaire scores were similar at 3 and 12 months. The intervention group spent significantly fewer days in hospital over 3 and 12 months (mean reduction 12.1 and 27.6 days respectively, P < 0.01), but spent a mean of 36 days in a care home rehabilitation service facility.

Conclusions: this service did not reduce institutionalisation, but diverted patients from the hospital to social services sector without major effects on activity levels or well-being.

Citation

Fleming, S. A., Blake, H., Gladman, J. R., Hart, E., Lymbery, M., Dewey, M. E., …Miller, P. (in press). A randomised controlled trial of a care home rehabilitation service to reduce long-term institutionalisation for elderly people. Age and Ageing, 33(4), https://doi.org/10.1093/ageing/afh126

Journal Article Type Article
Acceptance Date Feb 5, 2004
Online Publication Date May 19, 2004
Deposit Date Dec 13, 2016
Publicly Available Date Dec 13, 2016
Journal Age and Ageing
Print ISSN 0002-0729
Electronic ISSN 1468-2834
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 33
Issue 4
DOI https://doi.org/10.1093/ageing/afh126
Keywords health services for the aged, rehabilitation, care homes, randomised controlled trial, elderly
Public URL http://eprints.nottingham.ac.uk/id/eprint/39345
Publisher URL http://ageing.oxfordjournals.org/content/33/4/384
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf
Additional Information This is a pre-copyedited, author-produced version of an article accepted for publication in Age and Ageing following peer review. The version of record A randomised controlled trial of a care home rehabilitation service to reduce long-term institutionalisation for elderly people / Sarah A. Fleming , Holly Blake, John R.F. Gladman, Elizabeth Hart, Mark Lymbery, Michael E. Dewey, Helen McCloughry, Marion Walker and Paul Miller is available online at: http://ageing.oxfordjournals.org/content/33/4/384

Files

2004 Fleming et al RCT Care Homes.pdf (561 Kb)
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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





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