A non-randomised controlled trial of the Home Independence Program (HIP): an Australian restorative programme for older home-care clients

The Home Independence Program ( HIP) is a short-term restorative programme targeted at older home-care clients, who do not have a diagnosis of dementia, when they are first referred for assistance or when they are referred for additional services because their needs have increased. This study compared the outcomes for individuals who participated in HIP with those of individuals who received 'usual' home-care services. The study was conducted in metropolitan Perth, Western Australia, between 2001 and 2003, when HIP was being trialled as a service in just one region. One hundred clients were recruited into each group and were visited at home on three occasions - service start and at 3 months and 1 year. Standardised outcome measures were used to measure functional dependency, morale, confidence in performing everyday activities without falling and functional mobility. Service outcomes were also examined at 3 months and 1 year. The HIP group showed improvements on all personal outcome measures compared with the control group. These improvements were, except for the morale scale, significantly associated with group assignment even when baseline differences between the groups were adjusted for. As regards service outcomes, the odds of the individuals who received HIP still requiring services was 0.07 (95% CI = 0.03-0.15, P < 0.001) times those for the individuals in the control group at 3 months and 0.14 times at 12 months (95% CI = 0.07-0.29, P < 0.001). The results of this study supported the hypothesis that older individuals referred for home care who participated in a programme to promote their independence had better individual and service outcomes than individuals who received usual home care.