The Effect of Systematic Assessment of Functional Ability, Development of Rehabilitation Plan and Follow-up at Home for Elderly Medical Patients

The Effect of Systematic Assessment of Functional Ability, Development of Rehabilitation Plan and Follow-up at Home for Elderly Medical Patients

The aim of this study is to examine the effect of systematic assessment of functional ability, development of rehabilitation plan and follow-up at home for elderly medical patient's risk of readmission. The effect of the intervention is examined in a randomized controlled trial.

Inclusion Criteria:

• Patients admitted to, Medical Visitation Section (MVA) Aarhus University Hospital
• aged 65+
• resident in City of Aarhus.

Exclusion Criteria:

• Patients admitted from a psychiatric institution or nursing home
• patients without walking ability
• patients who do not speak or read Danish
• terminally ill patients
• patients transferred to other hospital departments