The effectiveness of intermediate care including transitional care interventions on function, healthcare utilisation and costs: a scoping review.

Autor: Sezgin D; School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland. duygu.sezgin@nuigalway.ie., O'Caoimh R; Department of Geriatric Medicine, Mercy University Hospital Cork, Cork, Ireland.; Clinical Sciences Institute, National University of Ireland Galway, Galway, Ireland., Liew A; Clinical Sciences Institute, National University of Ireland Galway, Galway, Ireland.; Department of Endocrinology, Portiuncula University Hospital, Ballinasloe, Co Galway, Ireland., O'Donovan MR; University College Cork, Cork, Ireland., Illario M; Campania Region Health Innovation Unit, and Federico II Department of Public Health, Naples, Italy., Salem MA; St Vincent De Paul LTC Facility, Luqa, Malta., Kennelly S; Royal College of Surgeons in Ireland Connolly Hospital, Dublin and Health Service Executive, Dublin, Ireland., Carriazo AM; Regional Ministry of Health and Families of Andalusia, Seville, Spain., Lopez-Samaniego L; Andalusian Public Foundation Progress and Health, Seville, Spain., Carda CA; REFiT Barcelona Research Group, Parc Sanitari Pere Virgili and Vall D'Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain., Rodriguez-Acuña R; Andalusian Public Foundation Progress and Health, Seville, Spain., Inzitari M; REFiT Barcelona Research Group, Parc Sanitari Pere Virgili and Vall D'Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain., Hammar T; Finnish Institute for Health and Welfare (THL), Helsinki, Finland., Hendry A; NHS Lanarkshire, Bothwell, UK.; School of Health and Life Sciences, University of the West of Scotland, Hamilton, UK.
Jazyk: angličtina
Zdroj: European geriatric medicine [Eur Geriatr Med] 2020 Dec; Vol. 11 (6), pp. 961-974. Date of Electronic Publication: 2020 Aug 04.
DOI: 10.1007/s41999-020-00365-4
Abstrakt: Background and Aim: Intermediate care describes services, including transitional care, that support the needs of middle-aged and older adults during care transitions and between different settings. This scoping review aimed to examine the effectiveness of intermediate care including transitional care interventions for middle-aged and older adults on function, healthcare utilisation, and costs.
Design: A scoping review of the literature was conducted including studies published between 2002 and 2019 with a transitional care and/or intermediate care intervention for adults aged ≥ 50. Searches were performed in CINAHL, Cochrane Library, EMBASE, Open Grey and PubMed databases. Qualitative and quantitative approaches were employed for data synthesis.
Results: In all, 133 studies were included. Interventions were grouped under four models of care: (a) Hospital-based transitional care (n = 8), (b) Transitional care delivered at discharge and up to 30 days after discharge (n = 70), (c) Intermediate care at home (n = 41), and (d) Intermediate care delivered in a community hospital, care home or post-acute facility (n = 14). While these models were associated with a reduced hospital stay, this was not universal. Intermediate including transitional care services combined with telephone follow-up and coaching support were reported to reduce short and long-term hospital re-admissions. Evidence for improved ADL function was strongest for intermediate care delivered by an interdisciplinary team with rehabilitation at home. Study design and types of interventions were markedly heterogenous, limiting comparability.
Conclusions: Although many studies report that intermediate care including transitional care models reduce hospital utilisation, results were mixed. There is limited evidence for the effectiveness of these services on function, institutionalisation, emergency department attendances, or on cost-effectiveness.
Databáze: MEDLINE
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