Process and outcome of care: comparison of two inpatient geriatric rehabilitation settings

Abstract

The objective of this study was to compare the process of care and outcome of rehabilitation in geriatric hospitals and in geriatric wards of general hospitals. It was longitudinal in design. Patients were interviewed on admission and on discharge. Data were retrieved from medical records and a questionnaire on the process of care was administered to staff members. Geriatric wards in four general hospitals and four independent geriatric hospitals in Israel provided the setting and approximately 50 consecutive admissions of patients with hip fracture or stroke, a total of 410 patients, were recruited from each setting. Four process indices and three outcome indices were used to measure quality of care. %

The main outcome showed that the functional status of the study population was higher on discharge than on admission and most patients were discharged to their former residence. When controlling for other variables, geriatric hospitals contributed more to higher functional status on discharge than did geriatric wards in general hospitals. Yet satisfaction with treatment was higher in geriatric wards in general hospitals than in geriatric hospitals. The main factors affecting patient satisfaction were functional status on discharge and the amount of rehabilitative treatment given.

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