Harris 2005.
| Study characteristics | ||
| Methods | Parallel randomised trial Dates of study not reported. |
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| Participants | Setting: New Zealand Patients had a broad range of diagnoses: fractures (28%); miscellaneous medical problems (18%); respiratory problems (16%); stroke and neurological diagnoses (14%); falls and injuries (11%); cardiac diagnoses (8%); and rehabilitation and other problems (5%). Number recruited: hospital at home: 39, hospital: 37 |
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| Interventions | Operated as a hospital outreach programme under the management of Auckland Hospital from the emergency department or acute assessment ward. A nurse‐led multidisciplinary team (physiotherapy, occupational therapy, social work) co‐ordinated care and rehabilitation for the patient within the patient's own home. There was a daily nursing review. Clinical responsibility was held by a dedicated hospital at home registrar, a consultant geriatrician, and in some cases the patient's GP, with 24‐hour on‐call medical cover. The service provided care 7 days a week with 10 hours of nursing care a day available, and a 24‐hour live‐in home caregiver if required. There was a daily nursing review, and a discharge handover to ongoing support services. The study included 2 treatment groups and a control (hospital) group. 1 treatment group was an "admission prevention" group and the other an "early discharge" group. We received IPD for the admission prevention and control groups only from the trialist. |
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| Outcomes | Activities of daily living, cognitive function, instrumental activities of daily living | |
| Notes | Follow‐up: 90 days Funding: Northern Regional Health Authority (New Zealand) Conflicts of interest: not reported Ethical approval: local ethics committee This author contributed IPD for a previous update of this review (Shepperd 2016a). |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Computer‐generated randomisation service |
| Allocation concealment (selection bias) | Low risk | Telephone randomisation service |
| Baseline outcome measurements (selection bias) | Low risk | Baseline outcome measurements done prior to intervention for activities of daily living, instrumental activities of daily living, and cognitive functioning; no relevant differences found |
| Baseline characteristics (selection bias) | Low risk | Baseline characteristics of the study and control groups are reported and are similar |
| Blinding of participants and personnel (performance bias) All outcomes | Low risk | Blinding of participants and personnel not possible Research staff did not make decision to admit to hospital |
| Blinding of outcome assessment (detection bias) Subjective outcomes | Low risk | Trained researchers not involved in patient care assessed participants for functional independence (FIM), cognitive function (MMSE), and instrumental activities of daily living (OARS) |
| Blinding of outcome assessment (detection bias) Objective outcomes | Low risk | Low risk for mortality, readmission, and measurement and valuation of costs |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Participants withdrawing: hospital at home: 4/143; hospital: 10/124 |
| Selective reporting (reporting bias) | Low risk | All outcomes reported (received trial data set) |