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Postacute care for older people in community hospitals: a multicenter randomized, controlled trial
John Young1, John Green, Anne Forster
1Academic Unit of Elderly Care and Rehabilitation, University of Leeds, Bradford Institute for Health Research, Bradford, West Yorkshire, United Kingdom. john.young@bradfordhospitals.nhs.uk
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.
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