Outcome of rehabilitation of older people in primary health care (completed)

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About the project

Populations are ageing and periods of hospitalisation are shortened in all developed countries. An increasing number of older patients are discharged from hospitals to primary health care with disabilities and need for rehabilitation. More disabled, older people also need effective rehabilitation in order to continue living independently in their homes and avoid staying in hospitals and nursing homes. To meet these rising demands, it is desirable for societies to develop effective and cost-effective methods of rehabilitation of older people within the primary health care. Only low level evidence is available about which rehabilitation methods are most effective.

Totally 302 patients, 202 and 100 in Model 1 and 2 respectively, aged >65 years, with stroke, osteoarthritis, hip fracture or other chronic diseases, presenting a rehabilitation potential. Referred from district hospital, nursing- or own homes.

Objectives

In this study we will compare the outcome of multi-disciplinary, structured rehabilitation of older patients in a district centre (Model 1) versus standard primary health care rehabilitation (Model 2).

Data collection and analyses of outcome of rehabiitation of older people in a district rehabilitation centre (Model 1).Data collection and analyses of outcome of rehabilitation of older people in communities with standard primary health care rehabilitation (Model 2). Manuscript submitted for publication: Structured community based inpatient rehabilitation of older patients is better than standard primary health care rehabilitation - an open comparative study
Recordings 18 months after rehabilitation in Model 1 and 2: Death, dependency and institutionalization. Analyses of predictors of outcome.

Study design: Open, prospective, comparative observational study

Outcomes

Primary: Sunnaas ADL Index (SI). Secondary: Umeaa Life Satisfaction Checklist (LSC). Cognitive (MMSE), emotional (SCL10) and marital status, residence, length of rehabilitation and hours/week care services were given. Follow up three and 18 months after rehabilitation.Three months results: Patients in Model 1 improved and persisted 1.9 points higher in SI (CI(0.99,2.81), p<0.001) compared to Model 2, in 2.4 weeks shorter rehabilitation (CI (1.6,3.1), p<0.001). LSC indicated similar satisfaction within both models. Fewer Model 1 patients received home care services > 3hours/week (OR=0.6 CI(0.4,0.8), p=0.002). Cognitive status predicted the SI gain positively, and level of care services negatively, in both models.

Financing

Scolarship from General Practice Research Foundation, University of Oslo, Norway.

Data collection in Model 2: Quality Foundation of the Norwegian Medical Association

Cooperation

  1. Department of General Practice/General Practice Research Unit, Institute of Health and Society, University of Oslo, Norway
  2. Sunnaas Rehabilitation Hospital and Medical Faculty, University of Oslo, Norway

Publications

Johansen I, Lindbaek M, Stanghelle JK, Brekke M. Structured community-based inpatient rehabilitation of older patients is better than standard primary health care rehabilitation - an open comparative study. Disabil Rehabil. 2012 Mar 28. [Epub ahead of print]

Johansen I, Lindbaek M, Stanghelle JK, Brekke M.
Effective rehabilitation of older people in a district rehabilitation center.
J Rehabil Med 2011 Apr; 43(5): 461-4

 

Published Aug. 19, 2011 1:13 PM - Last modified Feb. 17, 2020 8:54 AM