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Centre for Policy on Ageing | |
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From prevention of admission to improving discharge arrangements - interventions that impact on unscheduled bed days
— a mapping exercise ... on behalf of the Innovation Forum, Hertfordshire | | Author(s) | Frances Bunn, Karen Windle, Angela Dickinson |
| Corporate Author | Centre for Research in Primary and Community Care (CRIPACC), University of Hertfordshire |
| Publisher | Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, June 2005 |
| Pages | 71 pp |
| Source | Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield AL10 9AB. E-mail: a.m.dickinson@herts.ac.uk Website: www.herts.ac.uk/cripacc |
| Keywords | Admission [hospitals] ; Bed availability [hospitals] ; Discharge [hospitals] ; Usage [services] ; Preventative medicine ; Literature reviews. |
| Annotation | The mapping exercise was performed to identify interventions that reduce unscheduled acute hospital admissions for people aged 75+, and to provide the National Innovation Forum with an evidence base accordingly. Studies for inclusion were grouped into four main intervention categories, with 20 systematic reviews and 49 randomised controlled trials (RCTs) meeting inclusion criteria. First, 13 systematic reviews and 29 RCTs evaluated an intervention aimed at preventing an emergency admission. This included interventions such as comprehensive assessment, disease management, home visiting and medication review. Second, four RCTs evaluated an intervention to divert emergency attenders from admission to hospital, all concerning attendance with chest pains, and all finding a significant reduction in admissions. Third, six systematic reviews and 11 RCTs evaluated an intervention to reduce length of hospital stay; 4 of the systematic reviews of hospital at home or home care found a reduction in length of stay. Lastly, four systematic reviews and one RCT looked at interventions to improve discharge arrangements. Three of the reviews found evidence that discharge planning reduced hospital admissions and readmissions, while in one large review, this was found to be most effective when the intervention was provided in hospital and followed up with home assessment and care. Although inconsistent, the evidence provides some support for discharge planning, case management and chest pain observation units with the use of hospital protocols. In general, though, observation units seemed most effective when they were longitudinal, multidisciplinary, and integrated hospital and community care. (RH). |
| Accession Number | CPA-051214003 B |
| Classmark | LD:QKH: LD:QKW: LD:QKJ: QLD: LK2: 64A |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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