Home versus day rehabilitation: a randomised controlled trial

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Health Services Research

Background:

• Post-hospital rehabilitation is crucial for patient recovery and functional independence.
• Comparing different rehabilitation settings (home vs. day hospital) is essential for optimizing patient care.
• Existing research may not fully elucidate the comparative effectiveness of these models.

Purpose of the Study:

• To evaluate the impact of home-based versus hospital-based day rehabilitation on patient outcomes.
• To compare functional levels, quality of life, and readmission rates between the two rehabilitation models.

Main Methods:

• A randomized controlled trial involving 229 hospitalized patients undergoing ambulatory rehabilitation.
• Interventions included hospital-based day rehabilitation and home-based rehabilitation programs.
• Outcomes assessed at 3 and 6 months included hospital readmission, functional status, quality of life, and caregiver burden.

Main Results:

• Significant functional improvements were observed from baseline to 3 months for all participants.
• Patients in the day hospital group had double the risk of hospital readmission compared to the home rehabilitation group (RR = 2.1).
• Carers of day hospital patients reported significantly higher caregiver strain (Caregiver Strain Index scores).

Conclusions:

• Home-based post-hospital rehabilitation appears more favorable, associated with lower readmission rates.
• Day hospital rehabilitation may lead to increased hospital readmissions, potentially due to greater access to medical staff.
• The findings suggest home is a preferable setting for post-hospital rehabilitation to improve patient outcomes and reduce caregiver burden.