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Quality care outcomes following transitional care interventions for older people from hospital to home: a systematic review

Allen, Jacqueline, Hutchinson, Alison M., Brown, Rhonda and Livingston, Patricia M 2014, Quality care outcomes following transitional care interventions for older people from hospital to home: a systematic review, BMC health services research, vol. 14, no. 1, pp. 1-18, doi: 10.1186/1472-6963-14-346.

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Title Quality care outcomes following transitional care interventions for older people from hospital to home: a systematic review
Author(s) Allen, Jacqueline
Hutchinson, Alison M.ORCID iD for Hutchinson, Alison M. orcid.org/0000-0001-5065-2726
Brown, Rhonda
Livingston, Patricia M
Journal name BMC health services research
Volume number 14
Issue number 1
Start page 1
End page 18
Total pages 18
Publisher BioMed Central
Place of publication London, England
Publication date 2014-08
ISSN 1472-6963
Keyword(s) Transitional care
Discharge care
Discharge planning
Older person care
Aging
Systematic review
Summary  Background
Provision of high quality transitional care is a challenge for health care providers in many western countries. This systematic review was conducted to (1) identify and synthesise research, using randomised control trial designs, on the quality of transitional care interventions compared with standard hospital discharge for older people with chronic illnesses, and (2) make recommendations for research and practice.

Methods

Eight databases were searched; CINAHL, Psychinfo, Medline, Proquest, Academic Search Complete, Masterfile Premier, SocIndex, Humanities and Social Sciences Collection, in addition to the Cochrane Collaboration, Joanna Briggs Institute and Google Scholar. Results were screened to identify peer reviewed journal articles reporting analysis of quality indicator outcomes in relation to a transitional care intervention involving discharge care in hospital and follow-up support in the home. Studies were limited to those published between January 1990 and May 2013. Study participants included people 60 years of age or older living in their own homes who were undergoing care transitions from hospital to home. Data relating to study characteristics and research findings were extracted from the included articles. Two reviewers independently assessed studies for risk of bias.

Results
Twelve articles met the inclusion criteria. Transitional care interventions reported in most studies reduced re-hospitalizations, with the exception of general practitioner and primary care nurse models. All 12 studies included outcome measures of re-hospitalization and length of stay indicating a quality focus on effectiveness, efficiency, and safety/risk. Patient satisfaction was assessed in six of the 12 studies and was mostly found to be high. Other outcomes reflecting person and family centred care were limited including those pertaining to the patient and carer experience, carer burden and support, and emotional support for older people and their carers. Limited outcome measures were reported reflecting timeliness, equity, efficiencies for community providers, and symptom management.

Conclusions
Gaps in the evidence base were apparent in the quality domains of timeliness, equity, efficiencies for community providers, effectiveness/symptom management, and domains of person and family centred care. Further research that involves the person and their family/caregiver in transitional care interventions is needed.
Language eng
DOI 10.1186/1472-6963-14-346
Field of Research 111001 Aged Care Nursing
Socio Economic Objective 920211 Palliative Care
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2014, BioMed Central
Persistent URL http://hdl.handle.net/10536/DRO/DU:30065820

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Citation counts: TR Web of Science Citation Count  Cited 14 times in TR Web of Science
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Created: Thu, 18 Sep 2014, 15:26:18 EST by Jane Moschetti

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.