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Health Outcomes of Post‐Hospital In‐Home Team Care: Secondary Analysis of a Swedish Trial
Author(s) -
Melin Anna Lisa,
Wieland Darryl,
Harker Judith O.,
Bygren Lars Olov
Publication year - 1995
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1995.tb07343.x
Subject(s) - medicine , activities of daily living , randomized controlled trial , multivariate analysis , logistic regression , medical prescription , physical therapy , family medicine , nursing
Health Outcomes of Post‐Hospital In‐Home Team Care: Secondary Analysis of a Swedish Trial OBJECTIVE : To determine patient and treatment‐related factors predictive of health outcomes. DESIGN : Secondary analysis of a randomized trial with 6‐month follow‐up. After using bivariate and three‐way analysis in the total sample to screen outcome predictors and interactions among baseline variables, multivariate logistic regression was used to model outcomes. SETTING : A county general hospital in central Stockholm, and patients' homes nearby. PATIENTS : Hospital inpatients stable for discharge from acute care having at least one chronic condition, and dependent in 1 to 5 Katz activities of daily life (ADLs) were included. Subjects (mean age = 81.1 years) were randomized to “team” (n = 150) or “usual care” (n = 99). INTERVENTIONS : Team patients were eligible for in‐home primary care by an interdisciplinary team that included a physician, physical therapist, and 24‐hour nursing services and geriatric consultation where necessary. “Usual‐care” patients received standard district nurse‐administered services at home upon hospital discharge. MEASUREMENTS : Demographic, functional status, and medical characteristics were measured at randomization. Outcomes included survival and higher ADL, instrumental ADL (IADL), and outdoor ambulation scores. CONCLUSIONS : Heterogeneous clinical populations of older patients contain many prevalent characteristics important to outcomes. Secondary analysis of trials including interactions identifies treatable and untreatable risks, what program components may be effective, and who benefits. J Am Geriatr Soc 43: 301–307, 1995 .