Inpatient rehabilitation services for the frail elderly
Centre for Reviews and Dissemination
Record ID 32014001365
English
Authors' recommendations:
Vale of York CCG and City of York Council are looking to work with York Hospitals NHS Foundation Trust to improve inpatient rehabilitation care for the frail elderly.
There is a reasonable body of evidence to suggest that specialist inpatient rehabilitation services have the potential to improve patient outcomes compared to general care in a hospital setting.
A number of key characteristics of inpatient rehabilitation services for the frail elderly can be identified. These include the use of specially designated geriatric units, involvement of multidisciplinary teams and a system of comprehensive geriatric assessment to inform treatment and discharge.
Very limited data are reported for costs making it difficult to make informed judgments on the potential benefits of specialist inpatient rehabilitation services. As direct hospital costs appear broadly similar for specialist inpatient rehabilitation and usual care, it may be reasonable to assume that the potential for any cost reduction is likely to fall on social care.
From a CQUIN point of view, there is scope for incorporating a range of measures into the proposed framework. Functional improvement, readmission, nursing home avoidance and living at home were measured in most studies; length of stay used in isolation doesn't appear a reliable indicator of quality.
Consideration needs to be given to whether the patient populations represented in the evidence are truly reflective of the frail elderly presenting in practice; although aged over 65 years, none had dementia and all had potential for functional improvement.
Details
Project Status:
Completed
Year Published:
2013
URL for published report:
http://www.york.ac.uk/inst/crd/pdf/Inpatient%20rehabilitation%20services%20for%20the%20frail%20elderly.pdf
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
England
MeSH Terms
- Inpatients
- Rehabilitation
Contact
Organisation Name:
University of York
Contact Address:
University of York, York, Y01 5DD, United Kingdom. Tel: +44 1904 321040, Fax: +44 1904 321041,
Contact Name:
crd@york.ac.uk
Contact Email:
crd@york.ac.uk
Copyright:
University of York
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.