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Interventions aimed at reducing problems in adult patients discharged from hospital to home: a systematic meta-review

BACKGROUND: Many patients encounter a variety of problems after discharge from hospital and many discharge (planning and support) interventions have been developed and studied. These primary studies have already been synthesized in several literature reviews with conflicting conclusions. We therefor...

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Autores principales: Mistiaen, Patriek, Francke, Anneke L, Poot, Else
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1853085/
https://www.ncbi.nlm.nih.gov/pubmed/17408472
http://dx.doi.org/10.1186/1472-6963-7-47
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author Mistiaen, Patriek
Francke, Anneke L
Poot, Else
author_facet Mistiaen, Patriek
Francke, Anneke L
Poot, Else
author_sort Mistiaen, Patriek
collection PubMed
description BACKGROUND: Many patients encounter a variety of problems after discharge from hospital and many discharge (planning and support) interventions have been developed and studied. These primary studies have already been synthesized in several literature reviews with conflicting conclusions. We therefore set out a systematic review of the reviews examining discharge interventions. The objective was to synthesize the evidence presented in literature on the effectiveness of interventions aimed to reduce post-discharge problems in adults discharged home from an acute general care hospital. METHODS: A comprehensive search of seventeen literature databases and twenty-five websites was performed for the period 1994–2004 to find relevant reviews. A three-stage inclusion process consisting of initial sifting, checking full-text papers on inclusion criteria, and methodological assessment, was performed independently by two reviewers. Data on effects were synthesized by use of narrative and tabular methods. RESULTS: Fifteen systematic reviews met our inclusion criteria. All reviews had to deal with considerable heterogeneity in interventions, populations and outcomes, making synthesizing and pooling difficult. Although a statistical significant effect was occasionally found, most review authors reached no firm conclusions that the discharge interventions they studied were effective. We found limited evidence that some interventions may improve knowledge of patients, may help in keeping patients at home or may reduce readmissions to hospital. Interventions that combine discharge planning and discharge support tend to lead to the greatest effects. There is little evidence that discharge interventions have an impact on length of stay, discharge destination or dependency at discharge. We found no evidence that discharge interventions have a positive impact on the physical status of patients after discharge, on health care use after discharge, or on costs. CONCLUSION: Based on fifteen high quality systematic reviews, there is some evidence that some interventions may have a positive impact, particularly those with educational components and those that combine pre-discharge and post-discharge interventions. However, on the whole there is only limited summarized evidence that discharge planning and discharge support interventions have a positive impact on patient status at hospital discharge, on patient functioning after discharge, on health care use after discharge, or on costs.
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spelling pubmed-18530852007-04-20 Interventions aimed at reducing problems in adult patients discharged from hospital to home: a systematic meta-review Mistiaen, Patriek Francke, Anneke L Poot, Else BMC Health Serv Res Research Article BACKGROUND: Many patients encounter a variety of problems after discharge from hospital and many discharge (planning and support) interventions have been developed and studied. These primary studies have already been synthesized in several literature reviews with conflicting conclusions. We therefore set out a systematic review of the reviews examining discharge interventions. The objective was to synthesize the evidence presented in literature on the effectiveness of interventions aimed to reduce post-discharge problems in adults discharged home from an acute general care hospital. METHODS: A comprehensive search of seventeen literature databases and twenty-five websites was performed for the period 1994–2004 to find relevant reviews. A three-stage inclusion process consisting of initial sifting, checking full-text papers on inclusion criteria, and methodological assessment, was performed independently by two reviewers. Data on effects were synthesized by use of narrative and tabular methods. RESULTS: Fifteen systematic reviews met our inclusion criteria. All reviews had to deal with considerable heterogeneity in interventions, populations and outcomes, making synthesizing and pooling difficult. Although a statistical significant effect was occasionally found, most review authors reached no firm conclusions that the discharge interventions they studied were effective. We found limited evidence that some interventions may improve knowledge of patients, may help in keeping patients at home or may reduce readmissions to hospital. Interventions that combine discharge planning and discharge support tend to lead to the greatest effects. There is little evidence that discharge interventions have an impact on length of stay, discharge destination or dependency at discharge. We found no evidence that discharge interventions have a positive impact on the physical status of patients after discharge, on health care use after discharge, or on costs. CONCLUSION: Based on fifteen high quality systematic reviews, there is some evidence that some interventions may have a positive impact, particularly those with educational components and those that combine pre-discharge and post-discharge interventions. However, on the whole there is only limited summarized evidence that discharge planning and discharge support interventions have a positive impact on patient status at hospital discharge, on patient functioning after discharge, on health care use after discharge, or on costs. BioMed Central 2007-04-04 /pmc/articles/PMC1853085/ /pubmed/17408472 http://dx.doi.org/10.1186/1472-6963-7-47 Text en Copyright © 2007 Mistiaen et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Mistiaen, Patriek
Francke, Anneke L
Poot, Else
Interventions aimed at reducing problems in adult patients discharged from hospital to home: a systematic meta-review
title Interventions aimed at reducing problems in adult patients discharged from hospital to home: a systematic meta-review
title_full Interventions aimed at reducing problems in adult patients discharged from hospital to home: a systematic meta-review
title_fullStr Interventions aimed at reducing problems in adult patients discharged from hospital to home: a systematic meta-review
title_full_unstemmed Interventions aimed at reducing problems in adult patients discharged from hospital to home: a systematic meta-review
title_short Interventions aimed at reducing problems in adult patients discharged from hospital to home: a systematic meta-review
title_sort interventions aimed at reducing problems in adult patients discharged from hospital to home: a systematic meta-review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1853085/
https://www.ncbi.nlm.nih.gov/pubmed/17408472
http://dx.doi.org/10.1186/1472-6963-7-47
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