Young John, Green John, Forster Anne, Small Neil, Lowson Karin, Bogle Sue, George James, Heseltine David, Jayasuriya Tilak, Rowe Jed
Academic Unit of Elderly Care and Rehabilitation, University of Leeds, Bradford Institute for Health Research, Bradford, West Yorkshire, United Kingdom.
J Am Geriatr Soc. 2007 Dec;55(12):1995-2002. doi: 10.1111/j.1532-5415.2007.01456.x. Epub 2007 Nov 2.
To compare the effects of community hospital care on independence for older people needing rehabilitation with that of general hospital care.
Randomized, controlled trial.
Seven community hospitals and five general hospitals in the midlands and north of England.
Four hundred ninety patients needing rehabilitation after hospital admission with an acute illness.
Multidisciplinary team care for older people in community hospitals.
The primary outcome was the Nottingham extended activities of daily living scale (NEADL); secondary outcomes were the Barthel Index, Nottingham Health Profile, Hospital Anxiety and Depression Scale, mortality, discharge destination, 6-month residence status, and satisfaction with services.
Loss of independence at 6 months was significantly less likely in the community hospital group (mean adjusted NEADL change score group difference 3.27; 95% confidence interval 0.26-6.28; P=.03). The results for the secondary outcome measures were similar for the two groups.
Postacute community hospital rehabilitation care for older people is associated with greater independence.
比较社区医院护理与综合医院护理对需要康复治疗的老年人独立性的影响。
随机对照试验。
英格兰中部和北部的七家社区医院和五家综合医院。
490名因急性疾病入院后需要康复治疗的患者。
社区医院为老年人提供多学科团队护理。
主要结局指标是诺丁汉日常生活活动扩展量表（NEADL）；次要结局指标包括巴氏指数、诺丁汉健康量表、医院焦虑抑郁量表、死亡率、出院去向、6个月居住状况以及对服务的满意度。
社区医院组在6个月时失去独立性的可能性显著降低（平均调整后的NEADL变化评分组间差异为3.27；95%置信区间为0.26 - 6.28；P = 0.03）。两组次要结局指标的结果相似。
老年人急性病后在社区医院进行康复护理与更高的独立性相关。
