Evidence map›Paper›PMID 36737750›Full record

ArticleBMC health services research2023

Developing a model for rehabilitation in the home as hospital substitution for patients requiring reconditioning: a Delphi survey in Australia.

Roslyn G Poulos, Andrew M Cole, Kerry N Warner, Steven G Faux, Tuan-Anh Nguyen, Friedbert Kohler, Fey-Ching Un, Tara Alexander, Jacquelin T Capell, Dan R Hilvert and 2 more

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Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Roslyn G PoulosHammondCare, Sydney, Australia.
Andrew M ColeHammondCare, Sydney, Australia.
Kerry N WarnerHammondCare, Sydney, Australia.
Steven G FauxSchool of Population Health, UNSW, Sydney, Australia.
Tuan-Anh NguyenSouth Western Sydney Local Health District, Sydney, Australia.
Friedbert KohlerHammondCare, Sydney, Australia.
Fey-Ching UnHammondCare, Sydney, Australia.
Tara AlexanderAustralasian Rehabilitation Outcomes Centre, University of Wollongong, Wollongong, Australia.
Jacquelin T CapellAustralasian Rehabilitation Outcomes Centre, University of Wollongong, Wollongong, Australia.
Dan R HilvertHilvert Advisory, Sydney, Australia.
Claire Mc O'ConnorHammondCare, Sydney, Australia.
Christopher J PoulosHammondCare, Sydney, Australia. cpoulos@hammond.com.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundReconditioning for patients who have experienced functional decline following medical illness, surgery or treatment for cancer accounts for approximately 26% of all reported inpatient rehabilitation episodes in Australia. Rehabilitation in the home (RITH) has the potential to offer a cost-effective, high-quality alternative for appropriate patients, helping to reduce pressure on the acute care sector. This study sought to gain consensus on a model for RITH as hospital substitution for patients requiring reconditioning.

methodsA multidisciplinary group of health professionals working in the rehabilitation field was identified from across Australia and invited to participate in a three-round online Delphi survey. Survey items followed the patient journey, and also included items on practitioner roles, clinical governance, and budgetary considerations. Survey items mostly comprised statements seeking agreement on 5-point Likert scales (strongly agree to strongly disagree). Free text boxes allowed participants to qualify item answers or make comments. Analysis of quantitative data used descriptive statistics; qualitative data informed question content in subsequent survey rounds or were used in understanding item responses.

resultsOne-hundred and ninety-eight health professionals received an invitation to participate. Of these, 131/198 (66%) completed round 1, 101/131 (77%) completed round 2, and 78/101 (77%) completed round 3. Consensus (defined as ≥ 70% agreement or disagreement) was achieved on over 130 statements. These related to the RITH patient journey (including patient assessment and development of the care plan, case management and program provision, and patient and program outcomes); clinical governance and budgetary considerations; and included items for initial patient screening, patient eligibility and case manager roles. A consensus-based model for RITH was developed, comprising five key steps and the actions within each.

conclusionsStrong support amongst survey participants was found for RITH as hospital substitution to be widely available for appropriate patients needing reconditioning. Supportive legislative and payment systems, mechanisms that allow for the integration of primary care, and appropriate clinical governance frameworks for RITH are required, if broad implementation is to be achieved. Studies comparing clinical outcomes and cost-benefit of RITH to inpatient rehabilitation for patients requiring reconditioning are also needed.

Indexed as

Health PersonnelHospitalsRehabilitationAustraliaConsensusDelphi TechniqueHumansSurveys and QuestionnairesAllied healthCommunity rehabilitationDelphi studyPost-acute rehabilitationReconditioningRehabilitationRehabilitation in the home

Identifiers

PMID36737750
PMCPMC9895972

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.