Effects of preventive home visits to elderly people

• Published in: BMJ Vol. 307; no. 6895; pp. 27 - 32
• Main Authors: van Rossum, E, Frederiks, C M, Philipsen, H, Portengen, K, Wiskerke, J, Knipschild, P
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 03-07-1993; British Medical Association; BMJ Publishing Group LTD
• Subjects: Aged; Aged, 80 and over; Confidence interval; Control groups; Female; Follow-Up Studies; General Practice; Geriatric Assessment; Health Status; Home Care Services - statistics & numerical data; Home nursing; Hospital admissions; Hospitalization; Humans; Length of Stay; Male; Mortality; Netherlands - epidemiology; Nurses; Older adults; Outpatient clinics; Population studies; Preventive Health Services - statistics & numerical data; Psychoeducational intervention
• ISSN: 0959-8138; 1468-5833; 1756-1833
• DOI: 10.1136/bmj.307.6895.27

OBJECTIVES--To assess the effect of preventive home visits by public health nurses on the state of health of and use of services by elderly people living at home. DESIGN--Randomised controlled trial. SETTING--General population of elderly people in one of the southern regions of the Netherlands. SUBJECTS--580 subjects aged between 75 and 84 years randomly allocated to intervention (292) or control (288) group. INTERVENTIONS--Four visits a year over three years in intervention group. Control group received no home visits. MAIN OUTCOME MEASURES--Self rated health, functional state, well being, loneliness, aspects of the mental state (depressive complaints, memory disturbances), and mortality. Use of services and costs. RESULTS--Visits had no effect on the health of the subjects. In the group visited no higher scores were seen on health related measures, fewer died (42 (14%) v 50 (17%)), and community care increased slightly. In the control group more were referred to outpatient clinics (166 (66%) v 132 (55%)), and they had a 40% increased risk of admission (incidence rate ratio 1.4; 90% confidence interval 1.2 to 1.6). No differences were found in long term institutional care, and overall expenditure per person in the intervention group exceeded that in the control group by 4%. Additional analyses showed that visits were effective for subjects who initially rated their health as poor. CONCLUSIONS--Preventive home visits are not beneficial for the general population of elderly people living at home but might be effective when restricted to subjects with poor health.