Post-Acute Care for Older People Following Injury: A Randomized Controlled Trial.


Journal

Journal of the American Medical Directors Association
ISSN: 1538-9375
Titre abrégé: J Am Med Dir Assoc
Pays: United States
ID NLM: 100893243

Informations de publication

Date de publication:
03 2020
Historique:
received: 12 06 2019
revised: 20 08 2019
accepted: 23 08 2019
pubmed: 21 10 2019
medline: 24 6 2021
entrez: 21 10 2019
Statut: ppublish

Résumé

The study sought to determine whether older people, on discharge from hospital and on referral to a supported discharge team (SDT), will have: (1) reduced length of stay in hospital; (2) reduced risk of hospital readmission; and (3) reduced healthcare costs. Randomized controlled trial with follow-up at 4 and 12 months of post-acute home-based rehabilitation team (SDT). Programs were delivered by trained healthcare assistants, up to 4 times a day, 7 days a week, under the guidance of registered nurses, allied health, and geriatricians for up to 6 weeks. A total of 303 older women and 100 older men (mean age 81) in hospital because of injury, were randomized to either SDT (n = 201) or usual care (n = 202). The intervention was operated from Waikato hospital, a regional hospital in New Zealand. Days spent in hospital in the year following randomization and healthcare costs were collected from hospital datasets, and functional status assessed using the interRAI Contact Assessment was gathered by health professional research associates. Participants randomized to the SDT spent less time in hospital in the period immediately prior to discharge (mean 20.9 days) in comparison to usual care (mean 26.6 days) and spent less time in hospital in the 12 months following discharge home. Healthcare costs were lower in the SDT group in the 12 months following randomization. SDT can provide an important role in reducing hospital length of stay and readmissions of older people following an injury. Almost a million older people (65+ years of age) a year in the US are hospitalized as a consequence of falls-related injuries, most often fractured hip. Hospitals are not always the best location to provide care for older people. SDTs can help with the transition from hospital to home, while reducing hospital length-of-stay.

Identifiants

pubmed: 31629646
pii: S1525-8610(19)30631-0
doi: 10.1016/j.jamda.2019.08.015
pii:
doi:

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

404-409.e1

Informations de copyright

Copyright © 2019 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Auteurs

Matthew Parsons (M)

Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; Waikato District Health Board, Hamilton, New Zealand. Electronic address: m.parsons@auckland.ac.nz.

John Parsons (J)

Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; Waikato District Health Board, Hamilton, New Zealand.

Avinesh Pillai (A)

Faculty of Science, University of Auckland, Auckland, New Zealand.

Paul Rouse (P)

The Business School, The University of Auckland, Auckland, New Zealand.

Sean Mathieson (S)

Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.

Rochelle Bregmen (R)

Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.

Christine Smith (C)

Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.

Tim Kenealy (T)

Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.

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Classifications MeSH