Interventions to Promote Early Discharge and Avoid Inappropriate Hospital (Re)Admission: A Systematic Review

Alice Coffey, Patricia Leahy-Warren, Eileen Savage, Josephine Hegarty, Nicola Cornally, Mary Rose Day, Laura Sahm, Kieran O’Connor, Jane O’Doherty, Aaron Liew, Duygu Sezgin and Rónán O’Caoimh
Additional contact information
Alice Coffey: Department of Nursing and Midwifery, Health Sciences Building, University of Limerick, Limerick V94X5K6, Ireland
Patricia Leahy-Warren: School of Nursing and Midwifery, University College Cork, Cork City T12AK54, Ireland
Eileen Savage: Nursing and Vice Dean of Graduate Studies and Inter Professional Learning, College of Medicine and Health, University College Cork, Cork City T12AK54, Ireland
Josephine Hegarty: School of Nursing and Midwifery, University College Cork, Cork City T12AK54, Ireland
Nicola Cornally: School of Nursing and Midwifery, University College Cork, Cork City T12AK54, Ireland
Mary Rose Day: School of Nursing and Midwifery, University College Cork, Cork City T12AK54, Ireland
Laura Sahm: School of Pharmacy, University College Cork, Cork City T12T656, Ireland
Kieran O’Connor: Geriatric Medicine, Mercy University Hospital, Cork City T12WE28, Ireland
Jane O’Doherty: Department of Nursing and Midwifery, Health Sciences Building, University of Limerick, Limerick V94X5K6, Ireland
Aaron Liew: Clinical Sciences Institute, National University of Ireland, and Portiuncula University Hospital, Ballinasloe Galway H53T971, Ireland
Duygu Sezgin: Clinical Sciences Institute, National University of Ireland, and Portiuncula University Hospital, Ballinasloe Galway H53T971, Ireland
Rónán O’Caoimh: Clinical Sciences Institute, National University of Ireland, Galway City, Mercy University Hospital, Grenville Place, Cork City T12WE28, Ireland

IJERPH, 2019, vol. 16, issue 14, 1-16

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.

Keywords: discharge; admission; primary care; length of stay; transition; intermediate care; homecare; model; intervention; hospital avoidance (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4)

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