Interventions to Improve Hospital Admission and Discharge Management: An Umbrella Review of Systematic Reviews.
Journal
Quality management in health care
ISSN: 1550-5154
Titre abrégé: Qual Manag Health Care
Pays: United States
ID NLM: 9306156
Informations de publication
Date de publication:
Historique:
entrez:
1
4
2020
pubmed:
1
4
2020
medline:
9
3
2021
Statut:
ppublish
Résumé
The aim of this umbrella review was to summarize the research evidence on programs to improve the transition between ambulatory and hospital care. The MEDLINE database and the Cochrane library were searched. Systematic reviews of randomized controlled trials published between January 2000 and September 2018 in English or German were included. Studies were eligible if an assessment or coordination intervention had been evaluated and if patients had been transferred between hospital (defined as internal medicine, surgery, or unspecified hospital setting) and home (defined as any permanent residence). Risk of bias was assessed using the AMSTAR criteria. Results are presented descriptively and in table format. Thirty-nine systematic reviews comprising 492 different studies were included. More than half of these studies were conducted in the United States, the United Kingdom, Canada, and Australia. All studies evaluated strategies to improve discharge management (introduced after patients' arrival at the hospital); no study assessed strategies to improve admission management (initiated in primary care before patients' transition to hospital). The reviews included focused on a specific patient group, a specific intervention type, or a specific outcome. Overall, interventions focusing on elderly patients and high-intensity interventions seemed to be most effective. An overview of classifications of care transition strategies is provided. Future research should focus on hospital admission management programs.
Sections du résumé
BACKGROUND
The aim of this umbrella review was to summarize the research evidence on programs to improve the transition between ambulatory and hospital care.
METHODS
The MEDLINE database and the Cochrane library were searched. Systematic reviews of randomized controlled trials published between January 2000 and September 2018 in English or German were included. Studies were eligible if an assessment or coordination intervention had been evaluated and if patients had been transferred between hospital (defined as internal medicine, surgery, or unspecified hospital setting) and home (defined as any permanent residence). Risk of bias was assessed using the AMSTAR criteria. Results are presented descriptively and in table format.
RESULTS
Thirty-nine systematic reviews comprising 492 different studies were included. More than half of these studies were conducted in the United States, the United Kingdom, Canada, and Australia. All studies evaluated strategies to improve discharge management (introduced after patients' arrival at the hospital); no study assessed strategies to improve admission management (initiated in primary care before patients' transition to hospital). The reviews included focused on a specific patient group, a specific intervention type, or a specific outcome. Overall, interventions focusing on elderly patients and high-intensity interventions seemed to be most effective. An overview of classifications of care transition strategies is provided.
CONCLUSIONS
Future research should focus on hospital admission management programs.
Identifiants
pubmed: 32224790
doi: 10.1097/QMH.0000000000000244
pii: 00019514-202004000-00003
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Pagination
67-75Références
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