Department of General Practice/General Practice Research Unit, Institute of Health and Society, University of Oslo, Oslo, Norway.
Disabil Rehabil. 2012;34(24):2039-46. doi: 10.3109/09638288.2012.667193. Epub 2012 Mar 28.
To compare the outcome of multi-disciplinary, structured rehabilitation of older patients in a district inpatient rehabilitation centre (Model 1) versus standard primary health care rehabilitation (Model 2).
Open, prospective, comparative observational study. Totally 302 patients, 202 in Model 1 and 100 in Model 2, aged ≥ 65 years, with stroke, osteoarthritis, hip fracture or other chronic diseases, considered to have a rehabilitation potential. Referred from district hospital, nursing- or own homes.
Primary: Sunnaas ADL Index (SI). Secondary: Umeaa Life Satisfaction Checklist (LSC). Cognitive (MMSE), emotional (SCL-10) and marital status, residence, length of rehabilitation and hours/week care services. Follow-up 3 months after end of rehabilitation.
Patients in Model 1 improved and persisted 1.9 points higher in SI (CI (1.0, 2.8), p < 0.001) compared to Model 2, with 2.4 weeks shorter rehabilitation (CI (1.6, 3.1), p < 0.001). LSC indicated similar satisfaction within both models. Fewer Model 1 patients received home care services >3 h/week (OR = 0.6 CI (0.4, 0.8), p = 0.002). Cognitive status predicted the SI gain positively, and level of care services negatively, in both models.
Disabled older patients increase their independency significantly more within shorter time upon structured, multi-disciplinary rehabilitation in a district inpatient centre compared to standard primary health care rehabilitation. [Box: see text].
比较在地区住院康复中心进行多学科、结构化康复治疗（模式 1）与标准初级保健康复治疗（模式 2）对老年患者的治疗结果。
开放性、前瞻性、对照观察性研究。共纳入 302 例患者，模式 1 组 202 例，模式 2 组 100 例，年龄均≥65 岁，患有中风、骨关节炎、髋部骨折或其他慢性疾病，被认为有康复潜力。患者从地区医院、护理院或自己的家中转来。
主要结果：Sunnaas 日常生活活动指数（SI）。次要结果：于默奥生活满意度问卷（LSC）。认知功能（MMSE）、情绪（SCL-10）和婚姻状况、居住情况、康复时间和每周护理服务时间。康复结束后 3 个月进行随访。
与模式 2 相比，模式 1 患者的 SI 提高了 1.9 分（CI（1.0，2.8），p < 0.001），康复时间缩短了 2.4 周（CI（1.6，3.1），p < 0.001）。两种模式的 LSC 均表明满意度相似。模式 1 中接受每周家庭护理服务>3 小时的患者较少（OR=0.6，CI（0.4，0.8），p=0.002）。两种模式中，认知状态均对 SI 增益有正向预测作用，而护理服务水平则有负向预测作用。
与标准初级保健康复治疗相比，结构多学科康复治疗在地区住院康复中心可使老年残疾患者在更短的时间内显著提高独立性。
