In-hospital interventions for reducing readmissions to acute care for adults aged 65 and over: An umbrella review

Tiffany Conroy, Louise Heuzenroeder, Rebecca Feo

Research output: Contribution to journalArticle

Abstract

. PURPOSE: The aim of this umbrella review was to synthesise existing systematic review evidence on the effectiveness of in-hospital interventions to prevent or reduce avoidable hospital readmissions in older people (≥65 years old). DATA SOURCES: A comprehensive database search was conducted in May 2019 through MEDLINE, EMBASE, CINAHL, the JBI Database of Systematic Reviews, DARE and Epistimonikas. STUDY SELECTION: Systematic reviews and other research syntheses, including meta-analyses, exploring the effectiveness of hospital-based interventions to reduce readmissions for people aged 65 and older, irrespective of gender or clinical condition, were included for review. If a review did not exclusively focus on this age group, but data for this group could be extracted, then it was considered for inclusion. Only reviews in English were included. DATA EXTRACTION: Data extracted for each review included the review objective, participant details, setting and context, type of studies, intervention type, comparator, and findings. RESULTS OF DATA SYNTHESIS: Twenty-nine reviews were included for analysis. Within these reviews, 11 intervention types were examined: in-hospital medication review, discharge planning, comprehensive geriatric assessment, early recovery after surgery, transitional care, interdisciplinary team care, in-hospital nutrition therapy, acute care geriatric units, in-hospital exercise, post-fall interventions for people with dementia, and emergency department-based palliative care. Except for discharge planning and transitional care, none of the interventions significantly reduced readmissions amongst older adults. CONCLUSION: There is limited evidence to support the effectiveness of existing hospital-based interventions to reduce readmissions for people aged 65 and older.

Bibliographical note

This author accepted manuscript is made available following 12 month embargo from date of publication (October 2019) in accordance with the publisher’s archiving policy
© The Author(s) 2020. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved.

Keywords

  • aged
  • elderly
  • hospitals
  • interventions
  • patient readmission
  • review

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