a randomised controlled trial to prevent hospital readmissions and loss of functional ability in high risk older adults a study protocol随机对照试验,以防止医院发生率以及丧失功能的能力在高风险老年人研究协议.pdfVIP

Courtney et al. BMC Health Services Research 2011, 11:202 /1472-6963/11/202 STUDY PROTOCOL Open Access A randomised controlled trial to prevent hospital readmissions and loss of functional ability in high risk older adults: a study protocol Mary D Courtney1,2, Helen E Edwards2,3, Anne M Chang2,3,4, Anthony W Parker3,5, Kathleen Finlayson2,3* and Kyra Hamilton2,3 Abstract Background: Older people have higher rates of hospital admission than the general population and higher rates of readmission due to complications and falls. During hospitalisation, older people experience significant functional decline which impairs their future independence and quality of life. Acute hospital services comprise the largest section of health expenditure in Australia and prevention or delay of disease is known to produce more effective use of services. Current models of discharge planning and follow-up care, however, do not address the need to prevent deconditioning or functional decline. This paper describes the protocol of a randomised controlled trial which aims to evaluate innovative transitional care strategies to reduce unplanned readmissions and improve functional status, independence, and psycho-social well-being of community-based older people at risk of readmission. Methods/Design: The study is a randomised controlled trial. Within 72 hours of hospital admission, a sample of older adults fitting the inclusion/exclusion criteria (aged 65 years and over, admitted with a medical diagnosis, able to walk independently for 3 meters, and at least one risk factor for readmission) are randomised into one of four groups: 1) the usual care control group, 2) the exercise and in-home/telephone follow-up intervention group, 3) the exercise only intervention group, or 4) the in-home/telephone follow-up only intervention group. The u