Home-based Rehabilitation Services Can Improve Patient Outcomes

Providing rehabilitation services in the home rather than the hospital bed can improve patient outcomes and create various efficiencies, according to a new study.
Published this week in the Australian Healthcare and Hospital Association’s (AHHA) academic journal, the Australian Health Review, the study highlights that Rehabilitation in the Home Services (RITH) can be a safe and effective alternative.
The study was undertaken  by the University of Western Australia and the Fremantle Hospital and Health Service and looked at 1350 cases managed by a well-established RITH service in WA.
"This study has provided some illuminating data that shows improvements in quality of life, delirium incidence and mortality rates among patients,” AHHA Chief Executive Alison Verhoeven says.
“Analysis of such data also helps identify future patients who may be at risk of a poor RITH outcome, thus ensuring hospital beds are prioritised for those most in need. Where a patient is not at risk, the RITH service can provide short-term patient-centred care for a wide range of conditions, while passing the indirect ‘hotel-type’ costs back onto the patient.”
The model sees patients assessed for RITH suitability while they are hospital inpatients, entering a ‘virtual ward’ upon discharge and commencing home-based rehabilitation based on their individual needs.
In the study, about 93 per cent of patients were successfully discharged following their ‘stay’ on the virtual ward, with negative outcomes occurring in 90 cases, including five deaths (0.4%) and 85 readmissions (6.3%).
Independent associations with negative outcomes were significantly linked to certain conditions in older age patients, such as orthopaedic conditions and longer inpatient length of stay, which almost doubled the chance of a patient’s negative outcome. It was also found that patients aged over 80 years were about three times more likely to have negative outcome.
“The study shows that, through using existing systems and databases, we are able to assess clinical outcomes of large RITH services, find useful predictors of poor outcomes and, ultimately, improve the way these services are run,” Ms Verhoeven said