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Review
. 2008 Oct 8;2008(4):CD003164.
doi: 10.1002/14651858.CD003164.pub2.

Care home versus hospital and own home environments for rehabilitation of older people

Derek Ward  1 , Amy Drahota, Diane Gal, Martin Severs, Taraneh P Dean
Affiliations
Review

Care home versus hospital and own home environments for rehabilitation of older people

Derek Ward et al. Cochrane Database Syst Rev. .

Abstract

Background: Rehabilitation for older people has acquired an increasingly important profile for both policy-makers and service providers within health and social care agencies. This has generated an increased interest in the use of alternative care environments including care home environments. Yet, there appears to be limited evidence on which to base decisions.This review is the first update of the Cochrane review which was published in 2003.

Objectives: To compare the effects of care home environments (e.g. nursing home, residential care home and nursing facilities) versus hospital environments and own home environments in the rehabilitation of older people.

Search strategy: We searched the Cochrane Effective Practice and Organisation of Care Specialised Register and Pending Folder, MEDLINE (1950 to March Week 3 2007), EMBASE (1980 to 2007 Week 13), CINAHL (1982 to March, Week 4, 2007), other databases and reference lists of relevant review articles were additionally reviewed. Date of most recent search: March 2007.

Selection criteria: Randomised controlled trials (RCTs), controlled clinical trials (CCTs), controlled before and after studies (CBAs) and interrupted time series (ITS) that compared rehabilitation outcomes for persons 60 years or older who received rehabilitation whilst residing in a care home with those who received rehabilitation in hospital or own home environments.

Data collection and analysis: Two review authors independently assessed trial quality and extracted data.

Main results: In this update, 8365 references were retrieved. Of these, 339 abstracts were independently assessed by 2 review authors, and 56 studies and 5 review articles were subsequently obtained. Full text papers were independently assessed by two or three review authors and none of these met inclusion criteria.

Authors' conclusions: There is insufficient evidence to compare the effects of care home environments versus hospital environments or own home environments on older persons rehabilitation outcomes. Although the authors acknowledge that absence of effect is not no effect. There are three main reasons; the first is that the description and specification of the environment is often not clear; secondly, the components of the rehabilitation system within the given environments are not adequately specified and; thirdly, when the components are clearly specified they demonstrate that the control and intervention sites are not comparable with respect to the methodological criteria specified by Cochrane EPOC group. The combined effect of these factors resulted in the comparability between intervention and control groups being very weak.

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Conflict of interest statement

None known.

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References

References to studies excluded from this review

Andersson 2002 {published data only}
    1. Andersson A, Levin LA, Öberg B, Månsson L. Health care and social welfare costs in home‐based and hospital‐based rehabilitation after stroke. Scandinavian Journal of Caring Sciences 2002;16:386‐92. - PubMed
Arinzon 2005 {published data only}
    1. Arinzon Z, Fidelman Z, Zuta A, Peisakh A, Berner YN. Functional recovery after hip fracture in old‐old elderly patients. Archives of Gerontology and Geriatrics 2005;40:327‐36. - PubMed
Askim 2004 {published data only}
    1. Askim T, Rohweder G, Lydersen S, Indredavik B. Evaluation of an extended stroke unit service with early supported discharge for patients living in a rural community. A randomised controlled trial. Clinical Rehabilitation 2004;18:238‐48. - PubMed
Askim 2006 {published data only}
    1. Askim T, Mørkved S, Indredavik B. Does an extended stroke unit service with early supported discharge have any effect on balance or walking speed?. Journal of Rehabilitation Medicine 2006;38:368‐74. - PubMed
Barone 2006 {published data only}
    1. Barone A, Giusti A, Pizzonia M, Razzano M, Palummeri E, Pioli G. A comprehensive geriatric intervention reduces short‐ and long‐term mortality in older people with hip fracture. Journal of the American Geriatrics Society 2006;54(7):1145‐7. - PubMed
Bautz‐Holter 2002 {published data only}
    1. Bautz‐Holter E, Sveen U, Rygh J, Rodgers H, Bruum WT. Early supported discharge of patients with acute stroke: a randomized controlled trial. Disability & Rehabilitation 2002;24(7):348‐55. - PubMed
Beloosesky 2002 {published data only}
    1. Beloosesky Y, Grinblat J, Epelboym B, Weiss A, Grosman B, Hendel D. Functional gain of hip fracture patients in different cognitive and functional groups. Clinical Rehabilitation 2002;16:321‐8. - PubMed
Boston 2001 {published data only}
    1. Boston NK, Boynton PM, Hood S. An inner city GP unit versus conventional care for elderly patients: prospective comparison of health functioning, use of services and patient satisfaction. Family Practice 2001;18(2):141‐8. - PubMed
Bowling 1991 {published data only}
    1. Bowling A, Formby J, Grant K, Ebrahim S. A randomized controlled trial of nursing home and long‐stay geriatric ward care for elderly people. Age and Ageing 1991;20:316‐24. - PubMed
Braun 1987 {published data only}
    1. Braun KL, Rose CL. Geriatric patient outcomes and costs in three settings: nursing home, foster family, and own home. Journal of The American Geriatrics Society 1987;35(5):387‐97. - PubMed
Bührlen 2002 {published data only}
    1. Bührlen B, Jäckel WH. Outpatient orthopaedic rehabilitation: treatment, outcomes and costs as compared to inpatient rehabilitation [Teilstationäre orthopädische Rehabilitation: Therapeutische Leistungen, Behandlungsergebnis und Kosten im Vergleich zur stationären Rehabilitation]. Rehabilitation 2002;41:148‐59. - PubMed
Chen 2000/2001 {published data only}
    1. Chen Q, Kane RL, Finch MD. The cost effectiveness of post‐acute care for elderly medicare beneficiaries. Inquiry Winter 2000/2001;37:359‐75. - PubMed
Chiu 1997 {published data only}
    1. Chiu L, Shyu WC, Chen TRJ. A cost‐effectiveness analysis of home care and community‐based nursing homes for stroke patients and their families. Journal of Advanced Nursing 1997;26:872‐8. - PubMed
Chiu 2001 {published data only}
    1. Chiu L, Shyu WC, Liu YH. Comparisons of the cost‐effectiveness among hospital chronic care, nursing home placement, home nursing care and family care for severe stroke patients. Journal of Advanced Nursing 2001;33(3):380‐6. - PubMed
Chuang 2005 {published data only}
    1. Chuang KY, Wu SC, Yeh MC, Chen YH, Wu CL. Exploring the associations between long‐term care and mortality rates among stroke patients. Journal of Advanced Nursing 2005;13(1):66‐74. - PubMed
Claesson 2003 {published data only}
    1. Claesson L, Gosman‐Hedström G, Fagerberg B, Blomstrand C. Hospital re‐admissions in relation to acute stroke unit care versus conventional care in elderly patients the first year after stroke: the Göteborg 70+ Stroke study. Age and Ageing 2003;32:109‐13. - PubMed
Cohen 2002 {published data only}
    1. Cohen HJ, Feussner JR, Weinberger M, Carnes M, Hamdy RC, Hsieh F, et al. A controlled trial of inpatient and outpatient geriatric evaluation and management. The New England Journal of Medicine 2002;346(12):905‐12. - PubMed
Copp 1966 {published data only}
    1. Copp EP, Harris R. A further controlled trial of rehabilitation. Annals of Physical Medicine 1966;8(6):220‐3. - PubMed
Crotty 2005 {published data only}
    1. Crotty M, Whitehead CH, Wundke R, Giles LC, Ben‐Tovim D, Phillips PA. Transitional care facility for elderly people in hospital awaiting a long term care bed: randomised controlled trial. British Medical Journal 2005;331:1110‐4. - PMC - PubMed
Cunliffe 2004 {published data only}
    1. Cunliffe AL, Gladman JR, Husbands SL, Miller P, Dewey ME, Harwood RH. Sooner and healthier: a randomised controlled trial and interview study of an early discharge rehabilitation service for older people. Age and Ageing 2004;33:246‐52. - PubMed
Degischer 2002 {published data only}
    1. Degischer S, Labs KH, Hochstrasser J, Aschwanden M, Tschoepl M, Jaeger KA. Physical training for intermittent claudication: a comparison of structured rehabilitation versus home‐based training. Vascular Medicine 2002;7:109‐15. - PubMed
Deshpande 1998 {published data only}
    1. Deshpande SA, MacNeill SE, Lichtenberg PA, Pithadia J, Velez L. Functional outcome differences in acute versus subacute geriatric rehabilitation. Topics in Geriatric Rehabilitation 1998;13(4):30‐8.
Deutsch 2005 {published data only}
    1. Deutsch A, Granger CV, Fiedler RC, DeJong G, Kane RL, Ottenbacher KJ, et al. Outcomes and reimbursement of inpatient rehabilitation facilities and subacute rehabilitation programs for medicare beneficiaries with hip fracture. Medical Care 2005;43(9):892‐901. - PubMed
Deutsch 2006 {published data only}
    1. Deutsch A, Granger CV, Heinemann AW, Fiedler RC, DeJong G, Kane RL, et al. Poststroke rehabilitation: outcomes and reimbursement of inpatient rehabilitation facilities and subacute rehabilitation programs. Stroke 2006;37:1477‐82. - PubMed
Donnelly 2004 {published data only}
    1. Donnelly M, Power M, Russell M, Fullerton K. Randomized controlled trial of an early discharge rehabilitation service: the Belfast Community Stroke Trial. Stroke 2004;35:127‐33. - PubMed
Dubach 1993 {published data only}
    1. Dubach P, Litscher K, Kuhn M, Laske P, Buser P, Muller P, et al. Cardiac rehabilitation in Switzerland: efficacy of the residential approach following bypass surgery. Chest 1993;103(2):611‐5. - PubMed
Ellis 2006 {published data only}
    1. Ellis A, Trappes‐Lomax T, Fox M, Taylor R, Power M, Stead J, et al. Buying Time II: an economic evaluation of a joint NHS/Social Services residential rehabilitation unit for older people on discharge from hospital. Health and Social Care in the Community 2006;14(2):95‐106. - PubMed
Evans 2002 {published data only}
    1. Evans A, Harraf F, Donaldson N, Kalra L. Randomized controlled study of stroke unit care versus stroke team care in different stroke subtypes. Stroke 2002;33:449‐55. - PubMed
Fjærtoft 2003 {published data only}
    1. Fjærtoft H, Indredavik B, Lydersen S. Stroke unit care combined with early supported discharge; Long‐term follow‐up of a randomized controlled trial. Stroke 2003;34:2687‐92. - PubMed
Fjærtoft 2004 {published data only}
    1. Fjærtoft H, Indredavik B, Johnsen R, Lydersen S. Acute stroke unit care combined with early supported discharge: long‐term effects on quality of life. A randomized controlled trial. Clinical Rehabilitation 2004;18:580‐6. - PubMed
Fleming 2004 {published data only}
    1. Fleming SA, Blake H, Gladman JRF, Hart E, Lymbery M, Dewey ME, et al. A randomised controlled trial of a care home rehabilitation service to reduce long‐term institutionalisation for elderly people. Age and Ageing 2004;33:384‐90. - PubMed
Frytak 2001 {published data only}
    1. Frytak JR, Kane RA, Finch MD, Kane RL, Maude‐Griffin R. Outcome trajectories for assisted living and nursing facility residents in Oregon. Health Services Research 2001;36(1):91‐111. - PMC - PubMed
Giannini 2007 {published data only}
    1. Giannini R, Petazzoni E, Savorani G, Galletti L, Piscaglia F, Licastro F, et al. Outcomes from a program of home care attendance in very frail elderly subjects. Archives of Gerontology and Geriatrics 2007;44:95‐103. - PubMed
Griffiths 2001 {published data only}
    1. Griffiths P, Harris R, Richardson G, Hallett N, Heard S, Wilson‐Barnett J. Substitution of a nursing‐led inpatient unit for acute services: randomized controlled trial of outcomes and cost of nursing‐led intermediate care. Age and Ageing 2001;30:483‐8. - PubMed
Griffiths 2006 {published data only}
    1. Griffiths P. Moving elderly inpatients to a transitional care facility reduced hospital stay but increased time to transfer to long term care. Evidence Based Nursing 2006;9:90. - PubMed
Kalra 2000 {published data only}
    1. Kalra L, Evans A, Perez I, Knapp M, Donaldson N, Swift CG. Alternative strategies for stroke care: a prospective randomised controlled trial. The Lancet 2000;356:894‐9. - PubMed
Kane 1994 {published data only}
    1. Kane RL. A study of post‐acute care: Final Report #17‐C98891. Institute for Health Services Research. University of Minnesota School of Public Health, Minneapolis, 1994.
Kane 1996 {published data only}
    1. Kane RL, Chen Q, Blewett LA, Sangle J. Do rehabilitative nursing homes improve the outcomes of care?. The Journal of the American Geriatrics Society 1996;44(5):545‐54. - PubMed
Kane 1998 {published data only}
    1. Kane RL, Chen Q, Finch M, Blewett L, Burns R, Moskowitz M. Functional outcomes of posthospital care for stroke and hip fracture patients under medicare. The Journal of the American Geriatrics Society 1998;46(12):1525‐33. - PubMed
Kane 2000 {published data only}
    1. Kane RL, Chen Q, Finch M, Blewett L, Burns R, Moskowitz M. The optimal outcomes of post‐hospital care under medicare. Health Services Research 2000;35(3):615‐61. - PMC - PubMed
Keith 1995 {published data only}
    1. Keith RA, Wilson DB, Gutierrez P. Acute and subacute rehabilitation for stroke: A comparison. Archives of Physical Medicine and Rehabilitation 1995;76(6):495‐500. - PubMed
Kramer 1997 {published data only}
    1. Kramer AM, Steiner JF, Schlenker RE, Eilersten TB, Hrincevich CA, Tropea DA, et al. Outcomes and costs after hip fracture and stroke: A comparison of rehabilitation settings. Journal of the American Medical Association 1997;277(5):396‐404. - PubMed
Kramer 2000 {published data only}
    1. Kramer AM, Kowalsky JC, Lin M, Grigsby J, Hughes R, Steiner JF. Outcome and utilization differences for older persons with stroke in HMO and fee‐for‐service systems. Journal of the American Geriatrics Society 2000;48:726‐34. - PubMed
Kuisma 2002 {published data only}
    1. Kuisma R. A randomized, controlled comparison of home versus institutional rehabilitation of patients with hip fracture. Clinical Rehabilitation 2002;16:553‐61. - PubMed
Leeds 2004 {published data only}
    1. Leeds L, Meara J, Hobson P. The impact of discharge to a care home on longer term stroke outcomes. Clinical Rehabilitation 2004;18:924‐8. - PubMed
Levi 1997 {published data only}
    1. Levi SJ. Posthospital setting, resource utilization, and self‐care outcome in older women with hip fracture. Archives of Physical Medicine and Rehabilitation 1997;78:973‐9. - PubMed
Mayo 2000 {published data only}
    1. Mayo NE, Wood‐Dauphinee S, Côté R, Gayton D, Carlton J, Buttery J, et al. There's no place like home: an evaluation of early supported discharge for stroke. Stroke 2000;31:1016‐23. - PubMed
Miller 2005 {published data only}
    1. Miller P, Gladman JRF, Cunliffe AL, Husbands SL, Dewey ME, Harwood RH. Economic analysis of an early discharge rehabilitation service for older people. Age and Ageing 2005;34:274‐80. - PubMed
Munin 2005 {published data only}
    1. Munin MC, Seligman K, Dew MA, Quear T, Skidmore ER, Gruen G, et al. Effect of rehabilitation site on functional recovery after hip fracture. Archives of Physical Medicine and Rehabilitation 2005;86(3):367‐72. - PubMed
Philp 1991 {published data only}
    1. Philp I, Mutch WJ, Ballinger BR, Boyd L. A comparison of care in private nursing homes, geriatric and psychogeriatric hospitals. International Journal of Geriatric Psychiatry 1991;6:253‐8.
Polder 2003 {published data only}
    1. Polder JJ, Balen R, Steyerberg EW, Cools HJM, Habbema JDF. A cost‐minimisation study of alternative discharge policies after hip fracture repair. Health Economics 2003;12:87‐100. - PubMed
Reid 1989 {published data only}
    1. Reid J, Kennie DC. Geriatric rehabilitative care after fractures of the proximal femur: one year follow up of a randomised clinical trial. British Medical Journal 1989;299:25‐7. - PMC - PubMed
Reimer 2004 {published data only}
    1. Reimer MA, Slaughter S, Donaldson C, Currie G, Eliasziw M. Special care facility compared with traditional environments for dementia care: a longitudinal study of quality of life. Journal of the American Geriatrics Society 2004;52:1085‐92. - PubMed
Ronning 1998 {published and unpublished data}
    1. Ronning OM, Guldvog B. Outcome of subacute stroke rehabilitation: A randomized controlled trial. Stroke 1998;29(4):779‐84. - PubMed
Sanford 2006 {published data only}
    1. Sanford JA, Griffiths PC, Richardson P, Hargraves K, Butterfield T, Hoenig H. The effects of in‐home rehabilitation on task self‐efficacy in mobility‐impaired adults: a randomized clinical trial. Journal of the Americal Geriatrics Society 2006;54:1641‐8. - PubMed
Siggeirsdottir 2005 {published data only}
    1. Siggeirdottir K, Olafsson Ö, Jonsson Jr. H, Iwarsson S, Gudnason V, Jonsson BY. Short hospital stay augmented with education and home‐based rehabilitation improves function and quality of life after hip replacement: randomized study of 50 patients with 6 months of follow‐up. Acta Orthopaedica 2005;76(4):555‐62. - PubMed
Siu 2004 {published data only}
    1. Siu AMH, Chui DYY. Evaluation of a community rehabilitation service for people with rheumatoid arthritis. Patient Education and Counseling 2004;55:62‐9. - PubMed
Sulter 2003 {published data only}
    1. Sulter G, Elting JW, Langedijk M, Maurits NM, Keyser JD. Admitting acute ischemic stroke patients to a stroke care monitoring unit versus a conventional stroke unit: a randomized pilot study. Stroke 2003;34:101‐4. - PubMed
Trappes‐Lomax 2006 {published data only}
    1. Trappes‐Lomax T, Ellis A, Fox M, Taylor R, Power M, Stead J, et al. Buying time I: a prospective, controlled trial of a joint health/social care residential rehabilitation unit for older people on discharge from hospital. Health and Social Care in the Community 2006;14(1):49‐62. - PubMed
van Balen 2003 {published data only}
    1. Balen R. Early hospital discharge for elderly with a hip fracture. Better and cheaper?. Tijdschrift voor Verpleeghuisgeneeskunde 2003;27(3):12‐7.
von Sternberg 1997 {published data only}
    1. Sternberg T, Hepburn K, Cibuzar P, Convery L, Dokken B, Haefemeyer J, et al. Post‐hospital sub‐acute care: An example of a managed care model. The Journal of the American Geriatrics Society 1997;45(1):87‐91. - PubMed
Walsh 2006 {published data only}
    1. Walsh MB, Herbold J. Outcome after rehabilitation for total joint replacement at IRF and SNF; a case‐controlled comparison. American Journal of Physical Medicine and Rehabilitation 2006;85(1):1‐5. - PubMed
Weiss 2004 {published data only}
    1. Weiss Z, Snir D, Klein B, Avraham I, Shani R, Zetler H, et al. Effectiveness of home rehabilitation after stroke in Israel. International Journal of Rehabilitation Research 2004;27(2):119‐25. - PubMed
Williams 1994 {published data only}
    1. Williams MA, Oberst MT, Bjorklund BC. Early outcomes after hip fracture among women discharged home and to nursing homes. Research in Nursing and Health 1994;17:175‐83. - PubMed
Xie 2003 {published data only}
    1. Xie S, Mingguang Z, Xiaoli Z. Effect of early rehabilitation nursing on ability of daily living in patients with stroke. Zhongguo Linchuang Kangfu 2003;7(1):143.
Zhang 2003 {published data only}
    1. Zhang C. Effects of early post‐operation rehabilitation intervention on 69 patients with prolapse of lumbar intervertebral. Chinese Journal of Clinical Rehabilitation 2003;7(4):689.
Åberg 2003 {published data only}
    1. Åberg AC, Lindmark B, Lithell H. Evaluation and application of the General Motor Function assessment scale in geriatric rehabilitation. Diability and Rehabilitation 2003;25(7):360‐8. - PubMed

Additional references

Audit Comm' 1997
    1. Audit Commission. Coming of age: improving care services for older people. London: Audit Commission, 1997.
Audit Comm' 2000
    1. Audit Commission. The way to go home: rehabilitation and remedial services for older people. London: Audit Commission, 2000.
Berg 1997
    1. Berg K, Sherwood S, Murphy K, Carpenter GI, Gilgen R, Phillips CD. Rehabilitation in nursing homes: a cross‐national comparison of recipients. Age and Ageing 1997;26(Suppl 2):37‐42. [MEDLINE: ] - PubMed
Carpenter 2002
    1. Carpenter I, Gladman JRF, Parker SG, Potter J. Clinical and research challenges of intermediate care. Age and Ageing 2002;31(2):97‐100. - PubMed
Chamberlain 2003
    1. Chamberlain MA. Advances in rehabilitation: an overview and an odyssey. Clinical Medicine 2003;3(1):62‐7. - PMC - PubMed
Checkland 1993
    1. Checkland P. Systems Thinking, Systems Practice. Chichester: John Wiley and Sons Limited, 1993.
Checkland 1999
    1. Checkland P, Scholes J. Soft Systems Methodology in Action. Chichester: John Wiley and Sons Limited, 1999.
Dept of Defense 2000
    1. Department of Defense Systems Management College. Systems Engineering Fundamentals. Fort Belvoir Virginia 22060‐5565: Defense Acquisition University Press, Dec 2000.
DoH 2000
    1. Department of Health. Shaping the future NHS: long‐term planning for hospitals and related services ‐ Consultation document on the findings of the National Beds Inquiry. Department of Health. London, 2000.
DoH 2001
    1. Department of Health. Intermediate Care. HSC 2001/01:LAC (2001)1.
DoH 2004
    1. Department of Health. National Service Framework for Older People. Department of Health website: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Publicati... 2004.
Donabedian 1966
    1. Donabedian A. Evaluating the quality of medical care. Millbank Memorial Fund Quarterly 1966;44(3):Suppl:166‐206. - PubMed
Fulop 2001
    1. Fulop N, Allen P, Clarke A, Black N (Eds). Studying the Organisation and Delivery of Health Services: Research Methods. London: Routledge, 2001.
Glazsiou 2008
    1. Glazsiou P, Meats E, Heneghan C, Shepperd S. What is missing from descriptions of treatment in trials and reviews?. British Medical Journal 2008;336:1472‐4. - PMC - PubMed
Greener 2002
    1. Greener J, Langhorne P. Systematic reviews in rehabilitation for stroke: issues and approaches to addressing them. Clinical Rehabilitation 2002;16(1):69‐74. - PubMed
Haffey 1995
    1. Haffey WJ, Welsh JH. Subacute care: evolution in search of value. Archives of Physical Medicine and Rehabilitation 1995;76(12 Suppl):SC2‐4. [MEDLINE: ] - PubMed
Henwood 1995
    1. Henwood M. Tipping the Balance: Implications of changes in acute health care for patients and their families. National Association of Health Authorities and Trusts, Birmingham.. Birmingham, 1995.
Hoenig 2000
    1. Hoenig H, Sloane R, Horner RD, Zolkewitz M, Duncan PW, Hamilton BB. A taxonomy for classification of stroke rehabilitation services. Archives of Physical Medicine and Rehabilitation 2000;81(7):853‐62. - PubMed
Horowitz 2002
    1. Horowitz BP. Rehabilitation utilization in New York State: Implications for geriatric rehabilitation in 2015. Topics in Geriatric Rehabilitation 2002;17(4):78‐89.
IHCA 2000
    1. Independent Health Care Association. Convalescent homes to make a comeback. Guardian, 3 February 2000.
Joseph 1993
    1. Joesph CL, Wanlass W. Rehabilitation in the nursing home. Clinics in Geriatric Medicine 1993;9(4):859‐71. [MEDLINE: ] - PubMed
Juni 2001
    1. Juni P, Altman DG, Egger M. Systematic reviews in health care: assessing the quality of controlled clinical trials. British Medical Journal 2001;323(7303):42‐46. - PMC - PubMed
Jónsson 2003
    1. Jónsson Á, Gustafson Y, Schroll M, Hansen FR, Saarela M, Nygaard H, et al. Geriatric rehabilitation as an integral part of geriatric medicine in the Nordic countries. Danish Medical Bulletin 2003;50:439‐45. - PubMed
Keane‐Miller 2005
    1. Keane‐Miller D, Ellis T, Fetters L. Does the literature indicate that patients with a stroke have better outcomes after receiving rehabilitation from an acute rehabilitation facility than from a skilled nursing facility?. Physical Therapy 2005;85(1):67‐76. - PubMed
Keith 1995
    1. Keith RA, Wilson DB, Gutierrez P. Acute and subacute rehabilitation for stroke: a comparison. Archives of Physical Medicine & Rehabilitation 1995;76(6):495‐500. [MEDLINE: ] - PubMed
King's Fund 2000
    1. King's Fund Rehabilitation Programme Team. King's Fund Rehabilitation Development Network. London: King's Fund, 2000.
Kochersberger 1994
    1. Kochersberger G, Hielema F, Westlund R. Rehabilitation in the nursing home: how much, why and with what results. Public Health Reports 1994;109(3):372‐6. [MEDLINE: ] - PMC - PubMed
Kramer 1997
    1. Kramer AM, Steiner JF, Schlenker RE, Eilersten TB, Hrincevich CA, Tropea DA, Ahmad LA, Eckhoff DG. Outcomes and costs after hip fracture and stroke: a comparison of rehabilitation settings. Journal of the American Medical Association 1997;277(5):396‐404. [MEDLINE: ] - PubMed
Kramer 1999(a)
    1. Kramer AM, Coleman EA. Stroke rehabilitation in nursing homes: how do we measure quality?. Clinics in Geriatric Medicine 1999;15(4):869‐84. [MEDLINE: ] - PubMed
Kramer 1999(b)
    1. Kramer AM. Rehabilitation. In: Calkins E, Boult C, Wagner EH, Pacala JT editor(s). New ways to care for older people: building systems based on evidence in managed care. New York: Springer Publishing Company, 1999:118‐126.
Lubel 1998
    1. Lubel D. 'Blocked beds' survey: February 1998. British Geriatrics Society News 1998;February:3‐6.
MRC 2000
    1. Medical Research Council. A framework for development and evaluation of RCTs for complex interventions to improve health. MRC Health Services and Public Health Research Board April 2000.
Murray 1999
    1. Murray PK, Singer ME, Fortinsky R, Russo L, Cebul RD. Rapid growth of rehabilitation services in traditional community‐based nursing homes. Archives of Physical Medicine & Rehabilitation 1999;80(4):372‐8. [MEDLINE: ] - PubMed
Nazarko 1994
    1. Nazarko L. Nursing homes: past, present and future. Nursing Standard 1994;8(44):36‐9. [MEDLINE: ] - PubMed
Nazarko 1999
    1. Nazarko L. Rehabilitation. Nursing Management 1999;6(5):24‐7. [MEDLINE: ] - PubMed
Nocon 1998
    1. Nocon A, Baldwin S. Trends in rehabilitation policy. London: King's Fund, 1998.
Parker 1999
    1. Parker G, Phelps K, Shepperdson B, Bhakta P, Katbamna S, Lovett C. Best place of care for older people after acute and during sub‐acute illness: report of a national survey. University of Leicester: Nuffield Community Care Studies Unit, 1999.
Parker 2000
    1. Parker G, Bhakta P, Katbamna S, Lovett C, Paisley S, Parker S, et al. Best place of care for older people after acute and during subacute illness: a systematic review. Journal of Health Services Research and Policy 2000;5(3):176‐89. - PubMed
Ribbe 1999
    1. Ribbe MW, Fritjers DHM. Netherlands. In: Carpenter I, Challis D, Hirdes J, Ljunggren G, Bernabei R editor(s). Care of Older People: a comparison of systems in North America, Europe and Japan. London: Farrand Press, 1999.
Sinclair 1998
    1. Sinclair A, Dickinson E. Effective practice in rehabilitation: the evidence of systematic reviews. London: King's Fund, 1998.
Smyth 1976
    1. Smyth DS, Checkland PB. Using a systems approach: the structure of root definitions. Journal of Applied Systems Analysis 1976;5(1):75‐83.
Stevenson 2002
    1. Stevenson J, Spencer L. Developing Intermediate Care: a guide for health and social services professionals. London: King's Fund, 2002. - PubMed
Turrell 2001
    1. Turrell A. Nursing homes: a suitable alternative to hospital care for older people in the UK?. Age and Ageing 2001;30(S3):24‐32. - PubMed
Vaughan 1999
    1. Vaughan B, Lathlean J. Intermediate Care: models in practice. London: King's Fund, 1999.
Vähäkangas 2006
    1. Vähäkangas P, Noro A, Björkgren M. Provision of rehabilitation nursing in long‐term care facilities. Journal of Advanced Nursing 2006;55(1):29‐35. - PubMed
Wade 2001
    1. Wade D. Research into the black box of rehabilitation: the risks of a Type III error. Clinical Rehabilitation 2001;15:1‐4. - PubMed
Ward 2002
    1. Ward D, Severs M, Dean T. Care home environments, rehabilitation and older persons: a survey of current service provision within England. Managing Community Care: Building Knowledge for Integrated Care 2002;10(1):37‐42.
Ward 2003
    1. Ward D, Severs M, Dean T, Brooks N. Care home versus hospital and own home environments for rehabilitation of older people. Cochrane Database of Systematic Reviews 2003, Issue 2. [DOI: 10.1002/14651858.CD003164] - DOI - PubMed
Wilson 1996
    1. Wilson W. Systems: Concepts, Methodologies and Applications. 2nd Edition. Chichester: John Wiley and Sons Limited, 1996.