Aims: To identify and describe patient characteristics that differentiate patients admitted to a hospital-based versus home-based geriatric rehabilitation program.
Methods: This single-centre, case control study directly compared the acute medical, social and functional differences of sixty patients who underwent home-based or hospital-based geriatric rehabilitation between May and October 2022. Patients were previously community dwelling in the health service’s catchment area and transferred directly following an acute hospital admission. A retrospective medical record review of the individuals’ acute admission was used to identify features that may have influenced the admission to a hospital-based or home-based geriatric rehabilitation program.
Results: Mean age and sex were similar in both groups. Hospital-based rehabilitation was linked to falls without fracture (40% vs 13%, p=0.02), longer acute stays (9.2 vs 6.8 days, p=0.06), and higher delirium rates (60% vs 40%, p=0.12) with behavioural concerns (23% vs 10%, p=0.17) compared with home-based rehabilitation. Compared with hospital-based rehabilitation, home-based rehabilitation was associated with home assistance (60% vs 17%, p<0.01), existing community services (57% vs 23%, p=0.01), and independence in transfers (84% vs 17%, p<0.01), mobility (50% vs 7%, p<0.01), and toileting (50% vs 3%, p<0.01).
Conclusions: Patients undergoing home-based rehabilitation were more likely to be independent with mobility, toileting and have assistance at home compared with those managed in hospital. Patients who had falls, delirium with behavioural concerns, and needed physical assistance without home support were more likely to receive hospital-based services. These findings could inform future service development to enable more people to be treated at home.