{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T14:57:35Z","timestamp":1777474655724,"version":"3.51.4"},"reference-count":12,"publisher":"BMJ","issue":"6647","license":[{"start":{"date-parts":[[1988,8,20]],"date-time":"1988-08-20T00:00:00Z","timestamp":588038400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"published-print":{"date-parts":[[1988,8,20]]},"abstract":"<jats:p>STUDY OBJECTIVE--To compare a community support scheme using care attendants with standard aftercare for their effects on independence and morale of elderly patients discharged from hospital and on their use of health and social services. DESIGN--Randomised controlled study of cohort of patients over 75 discharged to their own homes. SETTING--District general hospital and community. PATIENTS--Total of 903 patients (mean age 82, 25% over 85). INTERVENTIONS--Total of 464 patients received support from care attendants on first day at home and for up to 12 hours a week for two weeks. Support comprised practical care, help with rehabilitation, and organising social help. The remaining 439 patients received standard aftercare. END POINT--Difference between two groups of 7% in hospital readmission rates or one point on activities of daily living scale (power 80%, significance level 5%). MEASUREMENTS AND MAIN RESULTS--Three months after the initial discharge 763 patients were interviewed (84%). There were no significant differences between the two groups in physical independence (activities of daily living scale), in measures of morale (Philadelphia scale), or in death rates. Hospital readmission rates within 18 months of discharge, however, were significantly higher in the control group and they spent more days in hospital (mean; control group 30.6 days, support group 17.1 days; p = 0.014). Of the patients living alone who were followed up for 18 months 21 (15%) receiving standard aftercare were readmitted more than twice compared with 6 (5%) supported by care attendants (p less than 0.01). CONCLUSIONS--If the findings are confirmed, and the policy extended to all patients over the age of 75 living alone, an average health district might expect either to save about 23 hospital beds at a net annual saving of about pounds 220,000 in the short term or to increase available beds by this number.<\/jats:p>","DOI":"10.1136\/bmj.297.6647.544","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T15:19:55Z","timestamp":1238685595000},"page":"544-547","source":"Crossref","is-referenced-by-count":102,"title":["Reduction in hospital readmission stay of elderly patients by a community based hospital discharge scheme: a randomised controlled trial."],"prefix":"10.1136","volume":"297","author":[{"given":"J.","family":"Townsend","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Piper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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Research prion'ties","author":"Department of Health and Social Security","year":"1981","unstructured":"Department of Health and Social Security. Research liaison groups for the elderly. Research prion'ties. London: HMSO, 1981."},{"key":"ref_3","article-title":"Home from hospuatal-provtdtng continuous care for elderly patients","author":"Skeet, M.","year":"1985","unstructured":"Skeet M. Home from hospuatal-provtdtng continuous care for elderly patients. London: King's Fund, 1985."},{"key":"ref_4","article-title":"Age Concern Greater London Health Forum. Policies, practices and projects: hospital discharge and aftercare in London","year":"1986","unstructured":"Age Concern Greater London Health Forum. Policies, practices and projects: hospital discharge and aftercare in London. London: Age Concern, 1986."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1136\/bmj.288.6414.369","article-title":"Effect of health visitors working with elderly patients in general practice: a randomised controlled trial","volume":"7","author":"Vetter, N.J.; Jones, D.A.; Victor, C.R.","year":"1984","unstructured":"Vetter NJ, Jones DA, Victor CR. Effect of health visitors working with elderly patients in general practice: a randomised controlled trial. Br Med J7 1984;288:369-72.","journal-title":"Br Med"},{"key":"ref_6","first-page":"1","article-title":"A new approach to community care for the elderly. British 7ournal ofSocial Work","volume":"10","author":"Challis, D.; Davies, B.","year":"1980","unstructured":"Challis D, Davies B. A new approach to community care for the elderly. British 7ournal ofSocial Work 1980;10:1-18."},{"key":"ref_7","article-title":"Population Censuses and Surveys. Census 1981. 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Int Rehabil Med 1979;1:51-8.","journal-title":"Int Rehabil Med"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1093\/geronj\/30.1.97","article-title":"Predictors of a dimension of well being in the relocated healthy aged","volume":"30","year":"1975","unstructured":"Storandt M, Wittels 1, Botwinick J. Predictors of a dimension of well being in the relocated healthy aged. 7 Gerontol 1975;30:97-102.","journal-title":"7 Gerontol"},{"key":"ref_10","first-page":"275","article-title":"Routine mental assessment in elderly patients","volume":"2","author":"Denham, M.J.; Jeffreys, P.M.","year":"1972","unstructured":"Denham MJ, Jeffreys PM. Routine mental assessment in elderly patients. Modern Geriatrics 1972;2:275.","journal-title":"Modern Geriatrics"},{"key":"ref_11","article-title":"Study of elderly pattents after discharge","author":"Brooke, C.; Yates, J.E.; Scott, B.J.","year":"1982","unstructured":"Brooke C, Yates JE, Scott BJ. Study of elderly pattents after discharge. Harrow: Northwick Park Hospital, 1982."},{"key":"ref_12","first-page":"68","article-title":"Distnrbution free statistical tests","author":"Bradley, J.V.","year":"1968","unstructured":"Bradley JV. Distnrbution free statistical tests. 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