Evaluating the impact of a home-based rehabilitation service on older people and their caregivers: a matched-control quasi-experimental study

• Published in: Clinical interventions in aging Vol. 13; pp. 1727 - 1737
• Main Authors: Lee, Iris Fung-Kam, Yau, Felix Ngok, Yim, Sally Suk-Ha, Lee, Diana Tze-Fan
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01-01-2018; Taylor & Francis Ltd; Dove Medical Press
• Subjects: Activities of Daily Living; Aged; Aged, 80 and over; Caregivers; Caregivers - psychology; Case-Control Studies; Elderly; Female; Fractures; Frailty; Health aspects; Home Care Services, Hospital-Based - organization & administration; Home-based service; Hong Kong - epidemiology; Hospitals; Humans; Independent Living; Male; Medical referrals; Middle Aged; Objectives; Occupational therapy; Older adults; Older people; Original Research; Outcome Assessment (Health Care); Patient Discharge - statistics & numerical data; Public health; Quality of Life; Quasi-experimental methods; Rehabilitation; Rehabilitation Research; Systematic review; Therapists; Hong Kong China; Caregiver Strain Index; hospital services utilization; community; elderly; Elderly Mobility Scale
• ISSN: 1178-1998; 1176-9092; 1178-1998
• DOI: 10.2147/CIA.S172871

Previous studies evaluating home-based rehabilitation service (HBRS) merely focused on the period immediately after the patients' discharge from hospitals. The present study focuses on HBRS that covers clients who have not been recently hospitalized. HBRS aims to meet older clients' rehabilitation needs and support their caregivers in the community. This study intended to evaluate the impact of HBRS on the older clients' health outcomes and hospital services utilization, and caregivers' strain in providing care for clients.
This study used a matched-control quasi-experimental design with a 3-month follow-up to evaluate HBRS. The health outcome measures used for the older clients included Elderly Mobility Scale, Timed Up and Go test, Modified Barthel Index, Lawton's Instrumental Activities of Daily Living Scale, Mini-Mental State Examination, and World Health Organization Quality of Life Scale, Short Form, Hong Kong version (WHOQOL-BREF [HK]). Meanwhile, the Caregiver Strain Index was used to measure the caregivers' caregiving strain. Data on clients' hospital services utilization 3 and 6 months before and after the study were also collected and evaluated.
The final sample consisted of 122 pairs of older clients and caregivers who live in a community in Hong Kong. In the follow-up after 3 months, the intervention group showed immensely substantial improvements across all the health outcome measures compared with the control group. The intervention group also demonstrated substantial reduction in the clients' hospital services utilization compared with the control group. However, no significant differences in the clients' hospital services utilization exist between the two groups in the follow-up after 6 months.
HBRS of this study is an effective intervention service to improve health outcomes and reduce hospital services utilization among older people living in the community. Moreover, HBRS of this study was effective in reducing the caregivers' caregiving strain.