Too many pre-discharge home assessment visits for older patients? A postal questionnaire survey

Abstract

OBJECTIVE: To investigate current practice of pre-discharge home assessment visits for older patients. DESIGN: Postal questionnaire survey. SETTING: NHS Trust hospitals in the United Kingdom. SUBJECTS: Occupational therapy departments in 265 NHS Trust hospitals which admit acutely ill older patients. MAIN OUTCOME MEASURES: The number of pre-discharge home visits done, who went, and therapy time spent on home visits. RESULTS: Of 265 NHS Trusts contacted, 239 (90%) replied. Of 238 units, 155 (65%) do between 11 and 40 visits per month, with 25 (11%) doing more than 60. The equivalent of one day per week or more is spent doing home visits by Senior I occupational therapists in 107 (45%) units and by Senior II staff in 126 (53%) units. Carers or relatives, unqualified occupational therapists, social workers and home care managers accompany the patient and occupational therapist on most home visits. CONCLUSION: Therapy perception is that pre-discharge home assessment visits are increasing in number, complexity and involvement of professional time despite little evidence for their effectiveness. Controlled trials are required to assess which patients are likely to benefit.