[Outpatient geriatric rehabilitation - the structural and process quality of a geriatric mobile service team and a community-based outpatient center]

Abstract

The trial "Outpatient Geriatric Rehabilitation (AMBRA)" has been launched to compare two outpatient rehabilitation models close to their place of residence or at home: a mobile rehabilitation team based at a geriatric hospital department and a community-based outpatient rehabilitation center run by GPs. Primary analyses concerning structural and process quality of the models are presented in this paper. They refer to medical features and factors associated with care which were assessed at the beginning of the rehabilitation procedures and during intervention. The models include 60 patients attended by the mobile rehabilitation team and 76 patients attended by the outpatient rehabilitation centre. The patients are suffering from multiple illnesses and are limited in their daily activities. Both teams co-ordinate interdisciplinary rehabilitation programs with an average of 50 therapeutic units per patient under medical supervision. The programs' focus is on physiotherapy and occupational therapy and, if indicated, on logotherapy. Psychosocial and health promotional offers are hardly integrated into the procedures. The mobile rehabilitation team on average cares for patients with better cognitive functions (Mini-Mental State Examination) but worse abilities to cope in daily life (Barthel index) than the outpatient rehabilitation team. These differences between rehabilitation groups remain significant after multivariate consideration of sociodemographic, morbidity and process factors. However, differences in mobility (Tinetti Test) can be explained by these variables. The future comparison of results of the rehabilitation programs must therefore consider the different baseline levels and determinants between both groups.