Evaluating Effectiveness of an Acute Rehabilitation Program in Hospital-Associated Deconditioning
Autor: | Pushpa Suriyaarachchi, Gustavo Duque, Laurence Chu, Anna Bishop, Piumali Gunawardene, Rose Cowan, Kate Matthews, Tina Thew |
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Rok vydání: | 2019 |
Předmět: |
Male
medicine.medical_specialty Activities of daily living medicine.medical_treatment law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Deconditioning law Acute care Activities of Daily Living Patient experience Humans Medicine 030212 general & internal medicine Functional ability Aged Retrospective Studies Aged 80 and over Inpatients Rehabilitation business.industry Retrospective cohort study Length of Stay Hospitals Patient Discharge Hospitalization Treatment Outcome Physical therapy Female Geriatrics and Gerontology business 030217 neurology & neurosurgery |
Zdroj: | Journal of Geriatric Physical Therapy. 43:172-178 |
ISSN: | 1539-8412 |
Popis: | BACKGROUND AND PURPOSE: Acute hospitalization can result in significant decline in functional ability, known as hospital-associated deconditioning. Older adults are most vulnerable, with resultant functional difficulties and increased risk of institutionalization. This study evaluates the effectiveness of a multidisciplinary acute rehabilitation program in hospital-associated deconditioning on routinely collected outcome data to examine its impact to determine whether a controlled trial is warranted. METHODS: We conducted a retrospective review of the hospital database for the national rehabilitation clinical registry for 2013 and 2014. We analyzed responses from patient feedback questionnaires over a 2-year period to assess patient experience of the rehabilitation program. RESULTS AND DISCUSSION: The analysis included 289 patients referred to our acute rehabilitation program. Most patients were aged 81-90 years, representing 47% (n = 137) of all admissions. The main impairment group was deconditioning (54%). The median entry time to the acute rehabilitation program for this impairment group was 5 days from admission and length of stay in the rehabilitation program was 9 days. Many of these patients (57%) were directly discharged home, with only 21% needing transfer for inpatient rehabilitation. The average Functional Independence Measure score gain was 22 for the patients directly discharged home, with an average discharge Functional Independence Measure score of 94/126. Of the patient feedback responses received (response rate: 24%), 96% rated the program as very good or good. We observed improved functional outcomes among program participants, with the majority directly discharged home, reduced transfer to rehabilitation hospitals, and patient acceptance of this acute rehabilitation program. CONCLUSION: These promising results suggest that a more rigorous evaluation of this acute rehabilitation program in the management of hospital-associated deconditioning is warranted. |
Databáze: | OpenAIRE |
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