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A physiotherapy service to an emergency extended care unit does not decrease admission rates to hospital: a

Christabel Jesudason1, Kathy Stiller, Matthew McInnes

  • 1Physiotherapy Department, Royal Adelaide Hospital, North Terrace, Adelaide, 5000 SA, Australia.

Emergency Medicine Journal : EMJ
|September 8, 2011
PubMed
Summary
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Physiotherapy in emergency extended care units (EECUs) did not significantly reduce hospital admissions or improve patient outcomes. This study found no significant differences in readmissions, community care use, or satisfaction compared to standard care.

Area of Science:

  • Geriatric Medicine
  • Rehabilitation Medicine
  • Emergency Medicine

Background:

  • Physiotherapy is utilized in emergency departments (EDs) and emergency extended care units (EECUs) to assess patient mobility for safe discharge.
  • Evaluating the impact of physiotherapy services in EECUs is crucial for optimizing patient care and resource allocation.

Purpose of the Study:

  • To determine if physiotherapy intervention in an EECU affects hospital admission rates.
  • To assess the impact of EECU physiotherapy on ED re-presentation rates.
  • To investigate effects on community healthcare utilization, functional recovery, and patient satisfaction.

Main Methods:

  • A randomized trial with concealed allocation, blinding, and intention-to-treat analysis was conducted in an EECU.
  • 186 patients (mean age 70) referred for physiotherapy were included, receiving either standard care or physiotherapy assessment/intervention.

Related Experiment Videos

  • The study analyzed differences in admission rates, re-presentations, community resource use, return to activities, and patient satisfaction.

    • Main Results:

    • The physiotherapy group showed a non-significant 4% lower rate of hospital admission (95% CI -18% to 9%).
    • There was a non-significant 4% higher rate of re-presentation to the ED (95% CI -6% to 13%).
    • No significant differences were observed in community healthcare resource use, return to usual activities, or patient satisfaction.

    Conclusions:

    • Physiotherapy services in EECUs, as implemented in this study, did not demonstrate a significant reduction in hospital admissions.
    • The intervention did not significantly improve re-presentation rates, community resource use, functional recovery, or patient satisfaction.
    • Further research may be needed to explore optimal models of physiotherapy integration in EECUs.