Systematic review of day hospital care for elderly people

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Abstract
Objective: To examine the effectiveness of day hospital attendance in prolonging independent living for elderly people. Design: Systematic review of 12 controlled clinical trials (available by January 1997) comparing day hospital care with comprehensive care (five trials), domiciliary care (four trials), or no comprehensive care (three trials). Subjects: 2867 elderly people. Main outcome measures: Death, institutionalisation, disability, global “poor outcome,” and use of resources. Results: Overall, there was no significant difference between day hospitals and alternative services for death, disability, or use of resources. However, compared with subjects receiving no comprehensive care, patients attending day hospitals had a lower odds of death or “poor” outcome (0.72, 95% confidence interval 0.53 to 0.99; PConclusions: Day hospital care seems to be an effective service for elderly people who need rehabilitation but may have no clear advantage over other comprehensive care. Methodological problems limit these conclusions, and further randomised trials are justifiable. The benefits of geriatric day hospital care have been controversial for many years This systematic review of 12 randomised trials comparing a variety of day hospitals with a range of alternative services found no overall advantage for day hospital care Day hospitals had a possible advantage over no comprehensive care in terms of death or poor outcome, disability, and use of resources The costs of day hospital care may be partly offset by a reduced use of hospital beds and institutional care among survivors