Article Text

other Versions

PDF
A physiotherapy service to an emergency extended care unit does not decrease admission rates to hospital: a randomised trial
  1. Christabel Jesudason1,
  2. Kathy Stiller1,
  3. Matthew McInnes1,
  4. Thomas Sullivan2
  1. 1Physiotherapy Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia
  2. 2Data Management and Analysis Centre, Discipline of Public Health, University of Adelaide, Adelaide, South Australia, Australia
  1. Correspondence to Dr Kathy Stiller, Physiotherapy Department, Royal Adelaide Hospital, North Terrace, Adelaide 5000, South Australia, Australia; kathy.stiller{at}health.sa.gov.au

Abstract

Background One of the reasons physiotherapy services are provided to emergency departments (EDs) and emergency extended care units (EECUs) is to review patients' mobility to ensure they are safe to be discharged home.

Aim To investigate whether a physiotherapy service to an EECU altered the rate of hospital admission, rate of re-presentation to the ED, visits to community healthcare practitioners, return to usual work/home/leisure activities and patient satisfaction.

Methods A randomised trial with concealed allocation, assessor blinding and intention-to-treat analysis was undertaken in an EECU. The sample comprised 186 patients (mean age 70 years, 123 (66%) female patients, 130 (70%) trauma) who were referred for physiotherapy assessment/intervention. Referral occurred at any stage of the patients' EECU admission. All participants received medical/nursing care as required. The physiotherapy group also received physiotherapy assessment/intervention.

Results The physiotherapy group had a 4% (95% CI −18% to 9%) lower rate of admission to hospital than the control group and a 4% (95% CI −6% to 13%) higher rate of re-presentation to the ED, which were statistically non-significant (p≥0.45). Differences between groups for use of community healthcare resources, return to usual work/home/leisure activities and satisfaction with their EECU care were small and not significant.

Conclusion A physiotherapy service for EECU patients, as provided in this study, did not reduce the rate of hospital admission, rate of re-presentation to the ED, use of community healthcare resources, or improve the rate of return to usual work/home/leisure activities or patient satisfaction.

Trial registration number ANZCTRN12609000106235.

  • Emergency service
  • hospital
  • physical therapy (specialty)
  • patient admission
  • patient discharge
  • randomised controlled trial
  • clinical management
  • cost effectiveness
  • musculoskeletal
  • soft tissue injury

Statistics from Altmetric.com

Footnotes

  • Funding The study was conducted with funding from the Royal Adelaide Hospital/Institute of Medical and Veterinary Science via a Clinical Research Grant for Allied Health, Pharmacy and Nursing.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Royal Adelaide Hospital Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.