A comprehensive rehabilitation service-produced by integration of existing facilities

Abstract

In 1984 two parallel arms of a rehabilitation service for elderly people were established using the resources of two geriatric wards and an adjacent rehabilitation centre. In the first four years 143 patients (median age 74) whose ultimate outcome for resettlement in the community was doubtful were managed jointly by the geriatric and rehabilitation services and were given a fully integrated programme of intensive rehabilitation in the rehabilitation centre (rehabilitation group). The majority of this group had suffered a cerebrovascular accident. A more frail group of 328 patients (median age 81) with various diagnoses received physiotherapy and occupational therapy in the ward setting (ward group). By the end of the first four years 63% of the rehabilitation group and 48% of the ward group had been discharged to the community. Only 3% of the former and 4% of the latter required long-term hospital care. Median attendance at the rehabilitation centre was 10 weeks and the median total inpatient stay for the rehabilitation group was 13 weeks, compared with seven weeks for the ward group.