Effects of intensive home visiting programs for older people with poor health status: A systematic review
Effects of intensive home visiting programs for older people with poor health status: A systematic review
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DOI：
10.1186/1472-6963-8-74
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发表时间：
2008-04-03
影响因子：
2.8
通讯作者：
Knipschild, Paul
中科院分区：
文献类型：
--
作者：
Bouman, Ans;van Rossum, Erik;Knipschild, Paul
背景：家访计划旨在改善老年人的健康和独立活动能力。此外，他们还打算减少住院和养老院的住院费用及相关费用。大量的研究调查了预防性家访项目对居住在社区的老年人的影响；调查结果并不一致。本综述的目的是评估针对健康状况不佳或有其他功能障碍的老年人的强化家访计划的有效性。方法：文献检索是基于2000年以后发表的关于家访有效性的四篇综述的纳入试验，以及2001年以后的中国医学研究中心、Cochrane中央对照试验登记中心、Embase、Medline和PsycINFO的数据库检索。我们还从可能相关的论文中手动检索了参考文献列表。随机对照试验包括评估干预计划的有效性，该计划包括每年至少四次家访，干预持续时间为12个月或更长，针对健康状况不佳的老年人（65岁及以上）。两名审稿人独立地从项目特征和结果测量的全文中提取数据；他们还评估了研究方法的质量。结果：检索到844篇摘要；8篇论文符合纳入标准。7项试验具有足够的方法学质量；在主要分析中，没有一项试验显示干预组与对照组在死亡率、健康状况、服务使用或费用方面有显著的有利影响。纳入针对体弱老年人的低强度干预计划不会对我们综述的结果产生很大影响。结论：我们得出结论，家访计划似乎对西方国家卫生保健机构中健康状况不佳的老年人没有好处。
Background: Home visiting programs have been developed aimed at improving the health and independent functioning of older people. Also, they intend to reduce hospital and nursing home admission and associated cost. A substantial number of studies have examined the effects of preventive home visiting programs on older people living in the community; the findings have been inconsistent. The objective of this review was to assess the effectiveness of intensive home visiting programs targeting older people with poor health or otherwise with functional impairments.Methods: A search for literature was based on included trials from four reviews on the effectiveness of home visits published after 2000 and on a database search of Cinahl, the Cochrane Central Register of Controlled Trials, Embase, Medline and PsycINFO from 2001 onwards. We also manually searched reference lists from potentially relevant papers. Randomized controlled trials were included assessing the effectiveness of intervention programs consisting of at least four home visits per year, an intervention duration of 12 months or more, and targeting older people (aged 65 years and over) with poor health. Two reviewers independently abstracted data from full papers on program characteristics and outcome measures; they also evaluated the methodological quality.Results: The search identified 844 abstracts; eight papers met the inclusion criteria. Seven trials were of sufficient methodological quality; none of the trials showed a significant favorable effect for the main analysis comparing the intervention group with the control group on mortality, health status, service use or cost. The inclusion of less-intensive intervention programs for frail older persons would not have exerted a great influence on the findings of our review.Conclusion: We conclude that home visiting programs appear not to be beneficial for older people with poor health within the health care setting of Western countries.