Effectiveness of early discharge planning in acutely ill or injured hospitalized older adults: a systematic review and meta-analysis.
Effectiveness of early discharge planning in acutely ill or injured hospitalized older adults: a systematic review and meta-analysis.
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DOI：
10.1186/1471-2318-13-70
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发表时间：
2013-07-06
期刊：
影响因子：
4.1
通讯作者：
Tregunno D
中科院分区：
文献类型：
--
作者：
Fox MT;Persaud M;Maimets I;Brooks D;O'Brien K;Tregunno D
年龄较大和视力较高与住院时间延长和再次住院有关。早期出院计划可能会减少住院时间和再入院率;然而，其对急性入院老年人的有效性尚不清楚。在这项系统性综述中，我们比较了早期出院计划与常规护理在缩短住院时间、再入院率、再入院住院时间和死亡率方面的有效性;并提高了因急性疾病或损伤入院的老年人对出院计划和生活质量的满意度。我们搜索了科克伦图书馆、DARE、HTA、NHSEED、ACP、MEDLINE、EMBASE、CINAHL、Proquest论文和论文、PubMed、Web of Science、SciSearch、PEDro、Sigma Theta Tau International的护理研究登记处、Joanna Briggs Institute、CRISP、OT Seeker和几个互联网搜索引擎。手工检索在四个老年学期刊和参考文献的所有纳入研究和以前的系统评价。两名评审员独立提取数据并评估偏倚风险。使用随机效应荟萃分析汇总数据。如果无法进行荟萃分析，则进行叙述分析。共纳入9项试验，共1736例受试者。与常规治疗相比，早期出院计划与索引医院出院后1 - 12个月内更少的再入院相关[风险比（RR）= 0.78，95% CI = 0.69 - 0.90];出院后3 - 12个月内的再入院时间较短[加权平均差（WMD）=-2.47，95%置信区间（CI）= −4.13 − −0.81）]。在住院时间、死亡率或出院计划满意度方面没有发现差异。四项研究的叙述分析表明，早期出院计划与更高的整体生活质量和一般健康领域的生活质量指数出院后两周。急性入院老年人的早期出院计划改善了索引医院出院后的系统水平结局。服务提供者可以利用这些发现来设计和实施早期出院计划，为患有急性疾病或受伤住院的老年人提供帮助。
Older age and higher acuity are associated with prolonged hospital stays and hospital readmissions. Early discharge planning may reduce lengths of hospital stay and hospital readmissions; however, its effectiveness with acutely admitted older adults is unclear. In this systematic review, we compared the effectiveness of early discharge planning to usual care in reducing index length of hospital stay, hospital readmissions, readmission length of hospital stay, and mortality; and increasing satisfaction with discharge planning and quality of life for older adults admitted to hospital with an acute illness or injury. We searched the Cochrane Library, DARE, HTA, NHSEED, ACP, MEDLINE, EMBASE, CINAHL, Proquest Dissertations and Theses, PubMed, Web of Science, SciSearch, PEDro, Sigma Theta Tau International’s registry of nursing research, Joanna Briggs Institute, CRISP, OT Seeker, and several internet search engines. Hand-searching was conducted in four gerontological journals and references of all included studies and previous systematic reviews. Two reviewers independently extracted data and assessed risk of bias. Data were pooled using a random-effects meta-analysis. Where meta-analysis was not possible, narrative analysis was performed. Nine trials with a total of 1736 participants were included. Compared to usual care, early discharge planning was associated with fewer hospital readmissions within one to twelve months of index hospital discharge [risk ratio (RR) = 0.78, 95% CI = 0.69 − 0.90]; and lower readmission lengths of hospital stay within three to twelve months of index hospital discharge [weighted mean difference (WMD) = −2.47, 95% confidence intervals (CI) = −4.13 − −0.81)]. No differences were found in index length of hospital stay, mortality or satisfaction with discharge planning. Narrative analysis of four studies indicated that early discharge planning was associated with greater overall quality of life and the general health domain of quality of life two weeks after index hospital discharge. Early discharge planning with acutely admitted older adults improves system level outcomes after index hospital discharge. Service providers can use these findings to design and implement early discharge planning for older adults admitted to hospital with an acute illness or injury.
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影响因子：
158.5
作者：
Inouye, SK;Bogardus, ST;Cooney, LW
通讯作者：
Cooney, LW
影响因子：
6.3
作者：
Fox, Mary T.;Sidani, Souraya;O'Brien, Kelly
通讯作者：
O'Brien, Kelly
影响因子：
5.7
作者：
KENNEDY, L;NEIDLINGER, S;SCROGGINS, K
通讯作者：
SCROGGINS, K
DOI：
10.1111/j.1532-5415.2000.tb03866.x
发表时间：
2000-12-01
影响因子：
6.3
作者：
Counsell, SR;Holder, CM;Landefeld, CS
通讯作者：
Landefeld, CS
影响因子：
11.4
作者：
Choong, PFM;Langford, AK;Santamaria, NM
通讯作者：
Santamaria, NM