What is the effectiveness and cost-effectiveness of at-home time-limited reablement service for improving an individual’s independence and health outcomes and reducing the need for long term care: a rapid review

Local authorities and health services in Wales are tasked with reablement, aimed at helping individuals who are at risk of frailty maintain and improve independence. However, certain social care constraints reduce resources for reablement services. The review aimed to identify evidence on the effectiveness and cost-effectiveness of at-home time-limited reablement services for improving an individual’s independence and health outcomes and reducing the need for long term care.

The review included available evidence to December 2024. Eighteen studies were included: 15 primary studies of clinical effectiveness; two economic evaluations; and one study of both clinical and cost-effectiveness.

There was a significant amount of evidence on the effectiveness of reablement interventions on person-related outcomes. The interventions were effective in improving outcomes associated with independent living and were effective in improving quality of life outcomes. Reablement interventions may be effective in improving falls outcomes, in reducing the risk of mortality, and improving clients’ coping in terms of sense of coherence. Strong international evidence indicates that reablement was effective in improving people’s ability to undertake mobility and daily living activities.

Thereview also identified a significant amount of evidence on the effectiveness of reablement interventions on service-level outcomes. Reablement reduced the need for long term home care services and was effective in reducing residential care admissions. In terms of other service-level outcomes, there were some contradictory and inconsistent findings on reablement’s effectiveness. One study found that reablement was effective in reducing the number of outpatient treatments compared with usual care.

The economic evaluations found reablement services were cost-effective when compared to standard at-home care, although there were some methodological flaws that limited the certainty of findings.

We identified the policy and practice implications, the need for further research and economic considerations.