Reduction in hospital readmission stay of elderly patients by a community based hospital discharge scheme: a randomised controlled trial.

摘要: STUDY OBJECTIVE--To compare a community support scheme using care attendants with standard aftercare for their effects on independence and morale of elderly patients discharged from hospital use health social services. DESIGN--Randomised controlled study cohort over 75 to own homes. SETTING--District general community. PATIENTS--Total 903 (mean age 82, 25% 85). INTERVENTIONS--Total 464 received first day at home up 12 hours week two weeks. Support comprised practical care, help rehabilitation, organising help. The remaining 439 aftercare. END POINT--Difference between groups 7% in readmission rates or one point activities daily living scale (power 80%, significance level 5%). MEASUREMENTS AND MAIN RESULTS--Three months after the initial discharge 763 were interviewed (84%). There no significant differences physical (activities scale), measures (Philadelphia death rates. Hospital within 18 discharge, however, significantly higher control group they spent more days (mean; 30.6 days, 17.1 days; p = 0.014). Of alone who followed 21 (15%) receiving readmitted than twice compared 6 (5%) supported by (p less 0.01). CONCLUSIONS--If findings are confirmed, policy extended all alone, an average district might expect either save about 23 beds net annual saving pounds 220,000 short term increase available this number.