Objective To examine the effectiveness of day hospital attendance in prolonging independent living for elderly people.
Design Systematic review of 12 controlled clinical trials (available by January 1997) comparing day hospital care with comprehensive care (five trials), domiciliary care (four trials), or no comprehensive care (three trials).
Subjects 2867 elderly people.
Main outcome measures Death, institutionalisation, disability, global « poor outcome, » and use of resources.
Results Overall, there was no significant difference between day hospitals and alternative services for death, disability, or use of resources.
However, compared with subjects receiving no comprehensive care, patients attending day hospitals had a lower odds of death or poor outcome (0.72,95% confidence interval 0.53 to 0.99 ; P<0.05) and functional deterioration (0.6 1,0.38 to 0.97 ; P<0.05).
The day hospital group showed trends towards reductions in hospital bed use and placement in institutional care.
Eight trials reported treatment costs, six of which reported that day hospital attendance was more expensive than other care, although only two analyses took into account cost of long term care.
Conclusions Day hospital care scents to be an effective service for elderly people who need rehabilitation but may have no clear advantage over other comprehensive care.
Methodological problems limit these conclusions, and further randomised trials are justifiable.
Mots-clés Pascal : Soin intégré, Hôpital jour, Questionnaire, Personne âgée, Homme, Evaluation, Article synthèse, Efficacité, Etude comparative, Grande Bretagne, Royaume Uni, Europe, Organisation santé
Mots-clés Pascal anglais : Managed care, Day hospital, Questionnaire, Elderly, Human, Evaluation, Review, Efficiency, Comparative study, Great Britain, United Kingdom, Europe, Public health organization
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0220234
Code Inist : 002B30A03B. Création : 16/11/1999.