Doctors prove home recovery is safe and effective

Fremantle Hospital researchers have confirmed rehabilitation in the home (RITH) is not only safe, but in some cases better for the patient than in-hospital rehabilitation.

The study, conducted by consultant geriatricians Sneha Bharadwaj and David Bruce, utilised the hospital's RITH database to investigate patient outcomes after moving to a 'virtual ward' in their home where they receive

specialist care similar to what they would receive in a hospital ward.

Professor Bruce says home rehabilitation for specific conditions like stroke and pulmonary disease have been well-researched, but the safety of the current home rehabilitation scheme needed re-examining.

"The home rehabilitation scheme has been going in Western Australia for quite a few years now and it has gradually developed to take on a broader mix of cases which might not be as safe and that's really what we wanted to look at," Prof Bruce says.

"One of the reasons we wanted to do this research was to make sure we weren't making mistakes and sending people home inappropriately because of pressure for beds or busy emergency rooms."

The study investigated all 1,348 RITH cases managed by the hospital in 2010.

Positive outcomes were found for an overwhelming number of home rehabilitation cases, with 93 per cent of cases being successfully discharged into the community without hospital re-admission.

Ageing patients tend to fail at RITH

The investigation found the major indicators of RITH failure were advanced age and length of hospital stay, and at least one of these indicators may be overcome.

Prof Bruce says there are two important ingredients to successful home rehabilitation.

"One is careful case selection. The other is a highly experienced and skilled home rehabilitation team," he says.

"These seem to be the important ingredients and with that we were able to safely take a broader case mix, most of which are older people."

Hospitals are the right place to be when you are sick, but not necessarily the best place for people who are recovering, Prof Bruce says.

"Patients are no longer patients at home. They are back to being themselves and are much more autonomous," he says.

"They don't have [to] ring a bell or ask somebody's permission to do something. They can make up their own minds.

"It's a different kind of care. It's a more focused and it's in their own home, so they're not having to stick to the hospital routine.

"It helps their mental state."