"These findings are important because a large number of older people receive home care services and they tend to have a large burden of illness and are at risk for functional decline," said Mary Tinetti, M.D., professor of medicine at Yale School of Medicine and lead author of the study. "This restorative approach to care appears to be both effective in maintaining or improving function and symptoms, in reducing the number of home care and emergency visits and potentially saving costs."

Optimizing patient function and comfort, particularly for older, chronically ill persons with multiple illnesses, is particularly important following episodes of acute illness and hospitalizations, Tinetti said.

"Between 25 percent and 50 percent of all hospitalized older persons experience loss of function or functional independence during hospitalization," she said in the study. "According to previous studies, only a third recover to pre-hospital levels of functioning by three months."

Traditionally, home care has been aimed at treating individual diseases. There is, however, a recent mandate by the federal Center for Medicare and Medicaid Services that attention be paid to functional outcomes of patients receiving home care as well, while reducing overall costs.

"The confluence of these mandates to both constrain costs yet improve outcomes provides the opportunity to investigate innovative and cost effective clinical strategies," Tinetti said.

The study compared the outcomes of 691 patients who received restorative care vs. a similar number of patients who received usual home care. The patients were 65 years of age or older, received at least seven days of home care, had no severe c
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Contact: Jacqueline Weaver
jacqueline.weaver@yale.edu
203-432-8555
Yale University
23-Apr-2002