Interventions to promote early discharge and avoid inappropriate hospital (re)admission: a systematic review.

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dc.contributor.author Coffey, Alice
dc.contributor.author Leahy-Warren, Patricia
dc.contributor.author Savage, Eileen
dc.contributor.author Hegarty, Josephine
dc.contributor.author Cornally, Nicola
dc.contributor.author Day, Mary Rose
dc.contributor.author Sahm, Laura J.
dc.contributor.author O'Connor, Kieran
dc.contributor.author O'Doherty, Jane
dc.contributor.author Liew, Aaron
dc.contributor.author Sezgin, Duygu
dc.contributor.author O'Caoimh, Rónán
dc.date.accessioned 2019-07-18T14:39:09Z
dc.date.available 2019-07-18T14:39:09Z
dc.date.issued 2019-07-10
dc.identifier.citation Coffey, A., Leahy-Warren, P., Savage, E., Hegarty, J., Cornally, N., Day, M. R., Sahm, L., O’Connor, K., O’Doherty, J., Liew, A., Sezgin, D. and O’Caoimh, R. (2019) 'Interventions to Promote Early Discharge and Avoid Inappropriate Hospital (Re)Admission: A Systematic Review', International Journal of Environmental Research and Public Health, 16(14), 2457 (16 pp). doi: 10.3390/ijerph16142457 en
dc.identifier.volume 16 en
dc.identifier.issued 14 en
dc.identifier.startpage 1 en
dc.identifier.endpage 16 en
dc.identifier.issn 1660-4601
dc.identifier.uri http://hdl.handle.net/10468/8207
dc.identifier.doi 10.3390/ijerph16142457 en
dc.description.abstract Increasing pressure on limited healthcare resources has necessitated the development of measures promoting early discharge and avoiding inappropriate hospital (re)admission. This systematic review examines the evidence for interventions in acute hospitals including (i) hospital-patient discharge to home, community services or other settings, (ii) hospital discharge to another care setting, and (iii) reduction or prevention of inappropriate hospital (re)admissions. Academic electronic databases were searched from 2005 to 2018. In total, ninety-four eligible papers were included. Interventions were categorized into: (1) pre-discharge exclusively delivered in the acute care hospital, (2) pre- and post-discharge delivered by acute care hospital, (3) post-discharge delivered at home and (4) delivered only in a post-acute facility. Mixed results were found regarding the effectiveness of many types of interventions. Interventions exclusively delivered in the acute hospital pre-discharge and those involving education were most common but their effectiveness was limited in avoiding (re)admission. Successful pre- and post-discharge interventions focused on multidisciplinary approaches. Post-discharge interventions exclusively delivered at home reduced hospital stay and contributed to patient satisfaction. Existing systematic reviews on tele-health and long-term care interventions suggest insufficient evidence for admission avoidance. The most effective interventions to avoid inappropriate re-admission to hospital and promote early discharge included integrated systems between hospital and the community care, multidisciplinary service provision, individualization of services, discharge planning initiated in hospital and specialist follow-up. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher MDPI en
dc.relation.uri https://www.mdpi.com/1660-4601/16/14/2457
dc.rights © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). en
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ en
dc.subject Discharge en
dc.subject Admission en
dc.subject Primary care en
dc.subject Length of stay en
dc.subject Transition en
dc.subject Intermediate care en
dc.subject Homecare en
dc.subject Model en
dc.subject Intervention en
dc.subject Hospital avoidance en
dc.title Interventions to promote early discharge and avoid inappropriate hospital (re)admission: a systematic review. en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Patricia Leahy-Warren, Nursing & Midwifery, University College Cork, Cork, Ireland. +353-21-490-3000 Email: patricia.leahy@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2019-07-16T10:08:56Z
dc.description.version Published Version en
dc.internal.rssid 493023004
dc.internal.pmid 31295933
dc.contributor.funder Health Service Executive, Ireland en
dc.description.status Peer reviewed en
dc.identifier.journaltitle International Journal of Environmental Research and Public Health en
dc.internal.copyrightchecked No
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress patricia.leahy@ucc.ie en
dc.internal.IRISemailaddress l.sahm@ucc.ie en
dc.identifier.articleid 2457 en


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© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Except where otherwise noted, this item's license is described as © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
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