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Hospital-at-home integrated care programme for older patients with orthopaedic conditions: Early community reintegration maximising physical function.
Maturitas ; 88: 65-9, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27105701
ABSTRACT

OBJECTIVE:

Older citizens with orthopaedic conditions need specialised care for the facilitation of early community reintegration and restitution of physical function. We introduced a new community care programme as an alternative to usual hospital rehabilitation for orthopaedic patients.

STUDY DESIGN:

This was an observational study of a cohort of older orthopaedic patients attending a hospital-at-home integrated care programme (HHU), compared with a contemporary cohort of users of a geriatric rehabilitation unit (GRU) in the urban area of Badalona, Catalonia, Spain.

MAIN OUTCOMES MEASURES:

Functional gain at discharge was measured using the Barthel Index (BI).

OTHER OUTCOMES WERE:

length of intervention (days), rehabilitation efficiency and discharge destination.

RESULTS:

Over the 2 years of the study we assessed 270 patients (69 at HHU; 201 at GRU). We found no significant differences in baseline characteristics between HHU and GRU groups-mean (IQR) or % age 83 (79-87) vs. 84 (79-88), cognitive impairment 27.5% vs. 24.9%, functional decline 40 (31-48) vs. 43 (32-58). Overall, we found no statistically significant differences between HHU and GRU groups on functional gain: 35 (22-45) vs. 32 (18-46), and discharge home 85.5% vs. 86.1%. Length of intervention was shorter in the HHU group, 43 (32-56) vs. 57 (44-81); p<0.01, for hip fracture patients. In a multivariate analysis, the adjusted mean difference in rehabilitation efficiency between HHU and GRU groups in the hip fracture subgroup was 0.27 (0.09 to 0.46); p=0.004.

CONCLUSIONS:

This hospital-at-home service obtained similar clinical results to the usual hospital-based rehabilitation care, and for hip fracture patients attending that service, rehabilitation efficiency was better.
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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Transtornos Cognitivos / Prestação Integrada de Cuidados de Saúde / Fraturas do Quadril / Hospitais Aspecto clínico: Etiologia Limite: Idoso / Feminino / Humanos / Masculino País/Região como assunto: Europa Idioma: Inglês Revista: Maturitas Ano de publicação: 2016 Tipo de documento: Artigo