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Older people

Early supported discharge

What is it?

Early supported discharge is a short term intervention designed to support early discharge from acute hospitals.

Does it work?

Yes. There is strong evidence from a number of studies for the effectiveness of services that support early discharge, through augmented medical and rehabilitation care in people’s homes or in community beds. 1 2 3 4 5 6

How does it work?

These services work by transferring medical and rehabilitation components of hospital-based post-acute care to community settings, (including the patient’s home, community hospitals, or in residential homes). The intervention works for frail older people in general as well as for people with specific old age-related conditions, such as hip fracture, pneumonia, heart failure and stroke. The intervention can be as expensive as traditional hospital care, and the impact on carer wellbeing is uncertain. Clinical outcomes are at least as good as traditional hospital care.

References

  1. Campbell H, Karnon J, Dowie R. Cost analysis of a hospital-at-home initiative using discrete event simulation. Journal of health services research & policy, 2001;6:14-22 External Link
  2. Crotty M, Whitehead C, Miller M, Gray S. Patient and caregiver outcomes 12 months after home-based therapy for hip fracture: a randomised controlled trial. Arch Phys Med Rehabil 2003;84:1237-9. External Link
  3. Diaz Lobato S, Gonzalez Lorenzo F, Gomez Mendieta MA, Mayoralas Alises S, Martin Arechabala I, Villasante Fernandez-Montes C. Evaluation of a home hospitalisation programme in patients with chronic obstructive pulmonary disease. Arch Bronconeumol 2005;41:5-10. External Link
  4. Crotty M, Whitehead CH, Gray S, Finucane PM. Early discharge and home rehabilitation after hip fracture achieves functional improvements: a randomized controlled trial. Clin Rehabil 2002;16:406-413. External Link
  5. Early Supported, Discharge Trialists. Services of reducing duration of hospital care for acute stroke patients. Cochrane Database Syst Rev: 2005;(2):CD000443. External Link
  6. Sheppard S, Iliffe S. Hospital at home versus in-patient hospital care. Cochrane Database Syst Rev 2005:(3):CD000356. External Link