• Maria Crotty, Maggie Killington, Enwu Liu, Ian D Cameron, Susan Kurrle, Billingsley Kaambwa, Owen Davies, Michelle Miller, Mellick Chehade, and Julie Ratcliffe.
• Rehabilitation, Aged and Extended Care, Flinders University, Finders Medical Centre, Level 4 Rehabilitation Building, Flinders Drive, Bedford Park SA, Australia.
• Age Ageing. 2019 May 1; 48 (3): 373-380.

Objectiveto determine whether a 4-week postoperative rehabilitation program delivered in Nursing Care Facilities (NCFs) would improve quality of life and mobility compared with receiving usual care.Designparallel randomised controlled trial with integrated health economic study.SettingNCFs, in Adelaide South Australia.Subjectspeople aged 70 years and older who were recovering from hip fracture surgery and were walking prior to hip fracture.Measurementsprimary outcomes: mobility (Nursing Home Life-Space Diameter (NHLSD)) and quality of life (DEMQOL) at 4 weeks and 12 months.Resultsparticipants were randomised to treatment (n = 121) or control (n = 119) groups. At 4 weeks, the treatment group had better mobility (NHLSD mean difference -1.9; 95% CI: -3.3, -0.57; P = 0.0055) and were more likely to be alive (log rank test P = 0.048) but there were no differences in quality of life. At 12 months, the treatment group had better quality of life (DEMQOL sum score mean difference = -7.4; 95% CI: -12.5 to -2.3; P = 0.0051), but there were no other differences between treatment and control groups. Quality adjusted life years (QALYs) gained over 12 months were 0.0063 higher per participant (95% CI: -0.0547 to 0.0686). The resulting incremental cost effectiveness ratios (ICERs) were $5,545 Australian dollars per unit increase in the NHLSD (95% CI: $244 to $15,159) and $328,685 per QALY gained (95% CI: $82,654 to $75,007,056).Conclusionsthe benefits did not persist once the rehabilitation program ended but quality of life at 12 months in survivors was slightly higher. The case for funding outreach home rehabilitation in NCFs is weak from a traditional health economic perspective.Trial RegistrationACTRN12612000112864 registered on the Australian and New Zealand Clinical Trials Registry. Trial protocol available at https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id = 361980.© The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society.

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