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How great a burden does early discharge to hospital-at-home impose on carers? A randomized controlled trial
D Gunnell1, J Coast, S H Richards
1Department of Social Medicine, University of Bristol, UK. D.J.Gunnell@Bristol.ac.uk
Objective:
to assess the effects of an early discharge hospital-at-home scheme on self-reported carer strain and quality of life.
Design:
a randomized controlled trial
Setting:
Bristol, UK.
Subjects:
133 carers of patients receiving either early discharge from hospital to hospital-at-home (n = 93) care or usual hospital care and discharge (n = 40).
Outcome Measures:
modified 12-item Carer Strain Index, COOP-WONCA charts and EuroQol EQ-5D at 4 weeks and 3 months post-randomization.
Results:
the mean age of carers was 65 years; 56% were women. There were no marked differences between the groups in any of the outcomes used at either 4-week or 3-month follow-up.
Conclusion:
there was no evidence of increased self-reported burden imposed on carers of patients discharged early from hospital. Decisions on the implementation of hospital-at-home schemes should be influenced by considerations of cost and effectiveness rather than effects on carers. The effects on carers may, however, differ for other forms of home-based care.
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