First author (year) | Main findings |
---|---|
Discharge protocol & advanced practice nurse | |
Naylor (1990) [72] | Significant reduction in rates of re-hospitalization for intervention group over the 12Â weeks post discharge |
No difference in length of stay | |
No difference in posthospital infections | |
Naylor (1994) [68] | Intervention patients in the medical units at 6Â week follow-up experienced: |
Significant delay in re-hospitalization to hospital | |
Fewer total days of re-hospitalisation | |
Lower health care costs (inclusive of inpatient, clinic, home visits) | |
No change in functional status, mental status, self-esteem or affect | |
Intervention caregivers up to 12Â weeks following discharge experienced: | |
No change in functional status, caregiving demands, family | |
functioning, affect | |
Naylor (1999) [77] | Intervention group at 24Â week follow-up experienced fewer: |
Re-hospitalizations | |
Hospital days per patient | |
Lower costs than control group | |
No statistically significant differences in functional status, depression or patient satisfaction between groups | |
Naylor (2004) [75] | The time to first admission was longer in intervention patients |
At 52Â weeks, intervention patients had fewer re-hospitalizations and lower total mean costs | |
There were short term improvements among intervention patients in quality of life (physical domain, up to 12Â weeks post discharge) and satisfaction with discharge and transition care (up to 6Â weeks post discharge) | |
Enguidanos (2012) [74] | No change in re-hospitalization rates at 6Â months following enrolment in the study |
The intervention group experienced significantly fewer visits to GPs | |
There were no changes between intervention and control groups in self-efficacy or satisfaction with service | |
General practitioner and primary care nurse models | |
Weinberger (1996) [67] | At 6Â months following discharge: |
Intervention group had significantly higher rates of re-hospitalization and if re-admitted longer in hospital stay than controls (discharge as usual). | |
Intervention group were significantly more satisfied with their care than controls | |
No differences in quality of life scores between groups | |
Quality of life scores were low in both groups | |
McInnes (1999) [73] | At 6, 12, 26Â weeks following discharge: |
No significant differences in length of stay, rates of re-hospitalization or time to first re-hospitalization | |
Intervention patients were significantly more likely to be | |
Referred to community services at discharge and report that hospital staff had discussed their discharge plan with them | |
Intervention patients reported increased satisfaction with discharge arrangements and preparation | |
Preen (2005) [66] | There were no differences in length of stay between groups |
One week following discharge: | |
GPs in the intervention group were more satisfied with the documentation | |
Discharge communication to GPs in the intervention was significantly faster than for GPs in the control group | |
Patients in the intervention group reported improved satisfaction with discharge planning, access to health services, confidence with discharge, and mental quality of life | |
Self-management and transition coaching | |
Coleman (2006) [69] | Intervention group had significantly lower re-hospitalization rates than the control group at 30, 90 and 180Â days post discharge |
Intervention group had significantly lower hospital costs than the control group at 30, 90 and 180Â days post discharge | |
Discharge case management | |
Lim (2003) [76] | Over 6Â month follow-up period there were no differences in rates of unplanned re-hospitalizations |
Intervention patients had significantly reduced length of stay (index hospitalisation) | |
Costs (hospital utilisation) lower in intervention patients over 6 | |
months following discharge | |
No differences in costs (utilisation of community services) | |
between groups | |
Significantly improved self-reported quality of life in intervention patients at one month follow-up | |
No difference in caregiver burden at 1Â month follow-up | |
Inpatient geriatric evaluation, co-management (with ward staff) and transitional care | |
Hansen (1995) [70] | At 6Â months following discharge: |
People in the intervention group were significantly less likely to be re-admitted to hospital than those in the control group | |
There were no differences in rates of admission to nursing homes or mortality rates | |
Significant increase in new and unforseen problems identified following discharge in people receiving the intervention. | |
Intervention participants were significantly more likely to be allocated home help. | |
Legrain (2011) [71] | Older people in the intervention group were significantly less likely to attend the emergency department or be re-admitted at 3Â months following discharge |
 | There were no differences between groups in ED attendances or re-hospitalizations at 6 months following discharge |