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Effects of locality based community hospital care on independence in older people needing rehabilitation: randomised controlled trial
Objective To determine the effects on independence in older people needing rehabilitation in a locality based community hospital compared with care on a ward for elderly people in a district general hospital. Design Randomised controlled trial. Setting Care in a community hospital and district gener...
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Published in: | BMJ 2005-08, Vol.331 (7512), p.317-320 |
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description | Objective To determine the effects on independence in older people needing rehabilitation in a locality based community hospital compared with care on a ward for elderly people in a district general hospital. Design Randomised controlled trial. Setting Care in a community hospital and district general hospital in Bradford, England. Participants 220 patients needing rehabilitation after an acute illness that required hospital admission. Interventions Patients were randomly allocated to a locality based community hospital or to remain within a department for the care of elderly people in a district general hospital. Main outcome measures Primary outcomes were Nottingham extended activities of daily living scale and general health questionnaire 28 (carer). Secondary outcomes were activities of daily living (Barthel index), Nottingham health profile, hospital anxiety and depression scale, mortality, destination after discharge, satisfaction with services, carer strain index, and carer's satisfaction with services. Results The median length of stay was 15 days for both the community hospital and the district general hospital groups (interquartile range: community hospital 9-25 days; district general hospital 9-24 days). Independence at six months was greater in the community hospital group (adjusted mean difference 5.30, 95% confidence interval 0.64 to 9.96). Results for the secondary outcome measures, including care satisfaction and measures of carer burden, were similar for both groups. Conclusions Care in a locality based community hospital is associated with greater independence for older people than care in wards for elderly people in a district general hospital. |
doi_str_mv | 10.1136/bmj.38498.387569.8F |
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Design Randomised controlled trial. Setting Care in a community hospital and district general hospital in Bradford, England. Participants 220 patients needing rehabilitation after an acute illness that required hospital admission. Interventions Patients were randomly allocated to a locality based community hospital or to remain within a department for the care of elderly people in a district general hospital. Main outcome measures Primary outcomes were Nottingham extended activities of daily living scale and general health questionnaire 28 (carer). Secondary outcomes were activities of daily living (Barthel index), Nottingham health profile, hospital anxiety and depression scale, mortality, destination after discharge, satisfaction with services, carer strain index, and carer's satisfaction with services. Results The median length of stay was 15 days for both the community hospital and the district general hospital groups (interquartile range: community hospital 9-25 days; district general hospital 9-24 days). Independence at six months was greater in the community hospital group (adjusted mean difference 5.30, 95% confidence interval 0.64 to 9.96). Results for the secondary outcome measures, including care satisfaction and measures of carer burden, were similar for both groups. Conclusions Care in a locality based community hospital is associated with greater independence for older people than care in wards for elderly people in a district general hospital.</description><edition>International edition</edition><identifier>ISSN: 0959-8138</identifier><identifier>ISSN: 0959-8146</identifier><identifier>EISSN: 1468-5833</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.38498.387569.8F</identifier><identifier>PMID: 15994660</identifier><identifier>CODEN: BMJOAE</identifier><language>eng</language><publisher>England: British Medical Journal Publishing Group</publisher><subject>Activities of Daily Living ; Aged ; Caregivers ; Clinical trials ; Community ; Community hospitals ; Comparative analysis ; Depressive disorders ; England ; Follow-Up Studies ; Health care outcome assessment ; Hospital admissions ; Hospital beds ; Hospitalization ; Hospitals ; Hospitals, Community - organization & administration ; Hospitals, District - organization & administration ; Humans ; Length of Stay ; Mortality ; Older adults ; Older people ; Patient Satisfaction ; Physicians ; Preadmission ; Primary care ; Prognosis ; Rehabilitation ; Rehabilitation - organization & administration ; Researchers ; Studies ; Subacute care ; Teaching hospitals</subject><ispartof>BMJ, 2005-08, Vol.331 (7512), p.317-320</ispartof><rights>2005 BMJ Publishing Group Ltd.</rights><rights>Copyright 2005 BMJ Publishing Group Ltd</rights><rights>Copyright: 2005 (c) 2005 BMJ Publishing Group Ltd.</rights><rights>Copyright BMJ Publishing Group Aug 6, 2005</rights><rights>Copyright © 2005, BMJ Publishing Group Ltd. 2005</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b589t-6539671c983aedd64f80148094755870e6a0c3d6dbf2f3344e3ebfe1c28733313</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmj.com/content/331/7512/317.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://bmj.com/content/331/7512/317.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>112,113,230,314,780,784,885,3194,27924,27925,30999,58238,58471,77594,77595</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15994660$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Green, John</creatorcontrib><creatorcontrib>Young, John</creatorcontrib><creatorcontrib>Forster, Anne</creatorcontrib><creatorcontrib>Mallinder, Karen</creatorcontrib><creatorcontrib>Bogle, Sue</creatorcontrib><creatorcontrib>Lowson, Karin</creatorcontrib><creatorcontrib>Small, Neil</creatorcontrib><title>Effects of locality based community hospital care on independence in older people needing rehabilitation: randomised controlled trial</title><title>BMJ</title><addtitle>BMJ</addtitle><description>Objective To determine the effects on independence in older people needing rehabilitation in a locality based community hospital compared with care on a ward for elderly people in a district general hospital. Design Randomised controlled trial. Setting Care in a community hospital and district general hospital in Bradford, England. Participants 220 patients needing rehabilitation after an acute illness that required hospital admission. Interventions Patients were randomly allocated to a locality based community hospital or to remain within a department for the care of elderly people in a district general hospital. Main outcome measures Primary outcomes were Nottingham extended activities of daily living scale and general health questionnaire 28 (carer). Secondary outcomes were activities of daily living (Barthel index), Nottingham health profile, hospital anxiety and depression scale, mortality, destination after discharge, satisfaction with services, carer strain index, and carer's satisfaction with services. Results The median length of stay was 15 days for both the community hospital and the district general hospital groups (interquartile range: community hospital 9-25 days; district general hospital 9-24 days). Independence at six months was greater in the community hospital group (adjusted mean difference 5.30, 95% confidence interval 0.64 to 9.96). Results for the secondary outcome measures, including care satisfaction and measures of carer burden, were similar for both groups. Conclusions Care in a locality based community hospital is associated with greater independence for older people than care in wards for elderly people in a district general hospital.</description><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Caregivers</subject><subject>Clinical trials</subject><subject>Community</subject><subject>Community hospitals</subject><subject>Comparative analysis</subject><subject>Depressive disorders</subject><subject>England</subject><subject>Follow-Up Studies</subject><subject>Health care outcome assessment</subject><subject>Hospital admissions</subject><subject>Hospital beds</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Hospitals, Community - organization & administration</subject><subject>Hospitals, District - organization & administration</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Mortality</subject><subject>Older adults</subject><subject>Older people</subject><subject>Patient Satisfaction</subject><subject>Physicians</subject><subject>Preadmission</subject><subject>Primary care</subject><subject>Prognosis</subject><subject>Rehabilitation</subject><subject>Rehabilitation - organization & administration</subject><subject>Researchers</subject><subject>Studies</subject><subject>Subacute care</subject><subject>Teaching hospitals</subject><issn>0959-8138</issn><issn>0959-8146</issn><issn>1468-5833</issn><issn>1756-1833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNqNkl2L1DAUhoso7jDuLxAlKOhVx6T53gtBhp1VGEYUPy5D2p7udGyTmnTE_QH-bzN2GD9A8SbJ4X3y5iR5s-w-wQtCqHhW9rsFVUyrNEou9EKtbmUzwoTKuaL0djbDmutcEarOsvMYdxjjgkqlBb-bnRGuNRMCz7Jvl00D1RiRb1DnK9u14w0qbYQaVb7v9-5Qb30c2tF2qLIBkHeodTUMkAZXQSqQ72oIaAA_dIAcQN26axRga8s2Gdqx9e4CBetq37eTtRuD77q0HENru3vZncZ2Ec6P8zx7v7p8t3yZr19fvVq-WOclV3rMBadaSFJpRS3UtWCNwoQprJnkXEkMwuKK1qIum6KhlDGgUDZAqkJJSimh8-z55Dvsyx7qClIbtjNDaHsbboy3rfldce3WXPsvhhBFSSGTwdOjQfCf9xBHky5UQddZB34fjRSs4LqgOpFP_kkKxZiW6U_m2aM_wJ3fB5eewRSYYVpIgRP0-G8QkVJhTog4nEknqgo-xgDN6WYEm0NsTIqN-REbM8XGqFXa9fDXR_m55xiSBDyYgF0cfTjpBWdJZCzp-aS3cYSvJ92GT0ZIKrnZfFiaNxu53hRXH83bxC8m_tDN_3T4HYgY51I</recordid><startdate>20050806</startdate><enddate>20050806</enddate><creator>Green, John</creator><creator>Young, John</creator><creator>Forster, Anne</creator><creator>Mallinder, Karen</creator><creator>Bogle, Sue</creator><creator>Lowson, Karin</creator><creator>Small, Neil</creator><general>British Medical Journal Publishing Group</general><general>British Medical Association</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>LK8</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7QJ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20050806</creationdate><title>Effects of locality based community hospital care on independence in older people needing rehabilitation: randomised controlled trial</title><author>Green, John ; Young, John ; Forster, Anne ; Mallinder, Karen ; Bogle, Sue ; Lowson, Karin ; Small, Neil</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b589t-6539671c983aedd64f80148094755870e6a0c3d6dbf2f3344e3ebfe1c28733313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Activities of Daily Living</topic><topic>Aged</topic><topic>Caregivers</topic><topic>Clinical trials</topic><topic>Community</topic><topic>Community hospitals</topic><topic>Comparative analysis</topic><topic>Depressive disorders</topic><topic>England</topic><topic>Follow-Up Studies</topic><topic>Health care outcome assessment</topic><topic>Hospital admissions</topic><topic>Hospital beds</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Hospitals, Community - organization & administration</topic><topic>Hospitals, District - organization & administration</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Mortality</topic><topic>Older adults</topic><topic>Older people</topic><topic>Patient Satisfaction</topic><topic>Physicians</topic><topic>Preadmission</topic><topic>Primary care</topic><topic>Prognosis</topic><topic>Rehabilitation</topic><topic>Rehabilitation - organization & administration</topic><topic>Researchers</topic><topic>Studies</topic><topic>Subacute care</topic><topic>Teaching hospitals</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Green, John</creatorcontrib><creatorcontrib>Young, John</creatorcontrib><creatorcontrib>Forster, Anne</creatorcontrib><creatorcontrib>Mallinder, Karen</creatorcontrib><creatorcontrib>Bogle, Sue</creatorcontrib><creatorcontrib>Lowson, Karin</creatorcontrib><creatorcontrib>Small, Neil</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biological Sciences</collection><collection>ProQuest research library</collection><collection>ProQuest Science Journals</collection><collection>ProQuest Biological Science Journals</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Green, John</au><au>Young, John</au><au>Forster, Anne</au><au>Mallinder, Karen</au><au>Bogle, Sue</au><au>Lowson, Karin</au><au>Small, Neil</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of locality based community hospital care on independence in older people needing rehabilitation: randomised controlled trial</atitle><jtitle>BMJ</jtitle><addtitle>BMJ</addtitle><date>2005-08-06</date><risdate>2005</risdate><volume>331</volume><issue>7512</issue><spage>317</spage><epage>320</epage><pages>317-320</pages><issn>0959-8138</issn><issn>0959-8146</issn><eissn>1468-5833</eissn><eissn>1756-1833</eissn><coden>BMJOAE</coden><abstract>Objective To determine the effects on independence in older people needing rehabilitation in a locality based community hospital compared with care on a ward for elderly people in a district general hospital. Design Randomised controlled trial. Setting Care in a community hospital and district general hospital in Bradford, England. Participants 220 patients needing rehabilitation after an acute illness that required hospital admission. Interventions Patients were randomly allocated to a locality based community hospital or to remain within a department for the care of elderly people in a district general hospital. Main outcome measures Primary outcomes were Nottingham extended activities of daily living scale and general health questionnaire 28 (carer). Secondary outcomes were activities of daily living (Barthel index), Nottingham health profile, hospital anxiety and depression scale, mortality, destination after discharge, satisfaction with services, carer strain index, and carer's satisfaction with services. Results The median length of stay was 15 days for both the community hospital and the district general hospital groups (interquartile range: community hospital 9-25 days; district general hospital 9-24 days). Independence at six months was greater in the community hospital group (adjusted mean difference 5.30, 95% confidence interval 0.64 to 9.96). Results for the secondary outcome measures, including care satisfaction and measures of carer burden, were similar for both groups. Conclusions Care in a locality based community hospital is associated with greater independence for older people than care in wards for elderly people in a district general hospital.</abstract><cop>England</cop><pub>British Medical Journal Publishing Group</pub><pmid>15994660</pmid><doi>10.1136/bmj.38498.387569.8F</doi><tpages>4</tpages><edition>International edition</edition><oa>free_for_read</oa></addata></record> |
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subjects | Activities of Daily Living Aged Caregivers Clinical trials Community Community hospitals Comparative analysis Depressive disorders England Follow-Up Studies Health care outcome assessment Hospital admissions Hospital beds Hospitalization Hospitals Hospitals, Community - organization & administration Hospitals, District - organization & administration Humans Length of Stay Mortality Older adults Older people Patient Satisfaction Physicians Preadmission Primary care Prognosis Rehabilitation Rehabilitation - organization & administration Researchers Studies Subacute care Teaching hospitals |
title | Effects of locality based community hospital care on independence in older people needing rehabilitation: randomised controlled trial |
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