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Effectiveness of home based support for older people: systematic review and meta-analysis

BMJ

Author: Elkan, R., Kendrick, D., Dewey, M., Hewitt, M., Robinson, J., Blair, M., Williams, D., Brummell, K.
Type: Journal Article
Year: 2001

Abstract:

Objective: To evaluate the effectiveness of home visiting programmes that offer health promotion and preventive care to older people., Design: Systematic review and meta-analysis of 15 studies of home visiting., Participants: Older people living at home, including frail older people at risk of adverse outcomes., Outcome measures: Mortality, admission to hospital, admission to institutional care, functional status, health status., Results: Home visiting was associated with a significant reduction in mortality. The pooled odds ratio for eight studies that assessed mortality in members of the general elderly population was 0.76 (95% confidence interval 0.64 to 0.89). Five studies of home visiting to frail older people who were at risk of adverse outcomes also showed a significant reduction in mortality (0.72; 0.54 to 0.97). Home visiting was associated with a significant reduction in admissions to long term care in members of the general elderly population (0.65; 0.46 to 0.91). For three studies of home visiting to frail, "at risk" older people, the pooled odds ratio was 0.55 (0.35 to 0.88). Meta-analysis of six studies of home visiting to members of the general elderly population showed no significant reduction in admissions to hospital (odds ratio 0.95; 0.80 to 1.09). Three studies showed no significant effect on health (standardised effect size 0.06; -0.07 to 0.18). Four studies showed no effect on activities of daily living (0.05; -0.07 to 0.17)., Conclusion: Home visits to older people can reduce mortality and admission to long term institutional care., (C) British Medical Journal 2001.


Further Details

Author Address: (1)School of Nursing, Postgraduate Division, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, (2)School of Community Health Sciences, Division of General Practice, Floor 13, Tower Building, University Park, Nottingham NG7 2RD, (3)School of Community Health Sciences, Trent Institute for Health Services Research, University of Nottingham, Queen's Medical Centre, Nottingham, (4)Evaluation Audit Centre for Research, Kingsmill Centre, Sutton in Ashfield, Nottinghamshire NG17 4JL, (5)Northwick Park and St Mark's NHS Trust, Harrow, Middlesex HA1 3UJ
Pages: 719-724
Volume: 323
Issue: 7315
Accession Number: November, 2010
Research Notes: Electronic copy added 30/08/213
Keywords: OlderhousingsafetyHealth
Reads: 195
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