The effectiveness of day hospital care on home care patients

Abstract

Objective: To study the effectiveness of rehabilitative and medically oriented day hospital care on community-based long-term care patients.

Design: A randomized, controlled trial.

Setting and participants: 177 patients on home-care in a rural area were randomized into two groups. Patients in one group were offered a 2-month period of rehabilitation and medical care in a recently opened day hospital, and in the other group patients were offered treatment, as before, in home care. Both groups were examined at the beginning and at 2, 5 and 12 months.

Intervention: Rehabilitative and medically oriented day hospital care.

Outcome measures: Use of health services, physical functioning measured by the Katz ADL Index, subjective health, symptoms, and satisfaction with care.

Results: The groups used hospitals (excluding the day hospital treatment) equally during the follow-up year. The treatment group had significantly more specialist consultations than did the control group. There were no clinically significant differences in the changes in the Katz ADL Index although more changes were found in the treatment group. The number of symptoms was reduced significantly in the treatment group, whereas the number of symptoms remained unchanged in the control group. The patients' views of their own health improved in the treatment group.

Conclusion: Day hospital care affects the quality of life of older people, but it does not reduce the use of other health services, nor does it clinically significantly improve the physical functioning of older people.