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

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dc.contributor.authorCoffey, Alice
dc.contributor.authorLeahy-Warren, Patricia
dc.contributor.authorSavage, Eileen
dc.contributor.authorHegarty, Josephine
dc.contributor.authorCornally, Nicola
dc.contributor.authorDay, Mary Rose
dc.contributor.authorSahm, Laura J.
dc.contributor.authorO'Connor, Kieran
dc.contributor.authorO'Doherty, Jane
dc.contributor.authorLiew, Aaron
dc.contributor.authorSezgin, Duygu
dc.contributor.authorO'Caoimh, Rónán
dc.contributor.funderHealth Service Executive, Irelanden
dc.date.accessioned2019-10-14T10:45:33Z
dc.date.available2019-10-14T10:45:33Z
dc.date.issued2019-07-10
dc.description.abstractIncreasing 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.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid2457en
dc.identifier.citationCoffey, 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 (16pp). DOI: 10.3390/ijerph16142457en
dc.identifier.doi10.3390/ijerph16142457en
dc.identifier.eissn1660-4601
dc.identifier.endpage16en
dc.identifier.issn1661-7827
dc.identifier.issued14en
dc.identifier.journaltitleInternational Journal of Environmental Research and Public Healthen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/8741
dc.identifier.volume16en
dc.language.isoenen
dc.publisherMDPIen
dc.relation.urihttps://www.mdpi.com/1660-4601/16/14/2457/htm
dc.rights© The Author(s) 2019. This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citeden
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subjectDischargeen
dc.subjectAdmissionen
dc.subjectPrimary careen
dc.subjectLength of stayen
dc.subjectTransitionen
dc.subjectIntermediate careen
dc.subjectHomecareen
dc.subjectModelen
dc.subjectInterventionen
dc.subjectHospital avoidanceen
dc.titleInterventions to promote early discharge and avoid inappropriate hospital (re)admission: a systematic reviewen
dc.typeArticle (peer-reviewed)en
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