A systematic Conroy S, Systematic review of Systemic No clear evidence of 14/16, review of 2011[] 5 Randomised review benefit of CGA to 88% comprehensive controlled trials prevent readmissions geriatric (2287 patients) from short hospital stays assessment to comparing usual RR 0.95 (95% CI 0.83 to improve care to CGA in 1.08). Also no significant outcomes for emergency benefit in terms of frail older departments or mortality. people being acute medical units rapidly discharged from acute hospital: ‘interface geriatrics’ Interventions to Linertova R, Systematic review of Narrative Most of the interventions 13/14, reduce hospital 2010[] 32 clinical trials (25 literature evaluated had no effect 93% readmission in RCTs, 7 CCTs) review on readmissions. the elderly: evaluating Those which included or interventions to post-discharge home home care. A reduce hospital care components systematic readmission in seemed more likely to review people >75 and reduce readmissions role of home follow up Interventions to Hansen L, 43 articles (patients 9/16 RCTs No single or bundled 12/14, reduce 30-day 2011[] 882,182) had sample intervention 86% size <100; implemented was Aims to describe a systematic other consistently associated interventions which review controlled with reduced risk for reduce studies; day rehospitalisation hospitalisation at 30 incomplete days post discharge reporting common Age group not specified Ellis G, Meta-analysis of 22 Meta-analysis Readmission rates no 15/16, Comprehensive 2011[] trials (10,315 different (3822 patients, 94% geriatric patients) RR 1.03 [0.89-1.18] but assessment for patients in receipt of older adults Aim to evaluate the CGA were more likely to admitted to effectiveness of CGA be alive and in their own hospital. in hospital for older homes at up to six Cochrane adults admitted as months review an emergency
A systematic review of comprehensive geriatric assessment to improve outcomes for frail older people being rapidly discharged from acute hospital: ‘interface geriatrics’ Conroy S, 2011[] Systematic review of 5 Randomised controlled trials (2287 patients) comparing usual care to CGA in emergency departments or acute medical units Systemic review No clear evidence of benefit of CGA to prevent readmissions from short hospital stays RR 0.95 (95% CI 0.83 to 1.08). Also no significant benefit in terms of mortality. 14/16, 88% Interventions to reduce hospital readmission in the elderly: or home care. A systematic review Linertova R, 2010[] Systematic review of 32 clinical trials (25 RCTs, 7 CCTs) evaluating interventions to reduce hospital readmission in people >75 and role of home follow up Narrative literature review Most of the interventions evaluated had no effect on readmissions. Those which included post-discharge home care components seemed more likely to reduce readmissions 13/14, 93% Interventions to reduce 30-day a systematic review Hansen L, 2011[] 43 articles (patients 882,182) Aims to describe interventions which reduce hospitalisation at 30 days post discharge Age group not specified 9/16 RCTs had sample size <100; other controlled studies; incomplete reporting common No single or bundled intervention implemented was consistently associated with reduced risk for rehospitalisation 12/14, 86% Comprehensive geriatric assessment for older adults admitted to hospital. Cochrane review Ellis G, 2011[] Meta-analysis of 22 trials (10,315 patients) Aim to evaluate the effectiveness of CGA in hospital for older adults admitted as an emergency Meta-analysis Readmission rates no different (3822 patients, RR 1.03 [0.89-1.18] but patients in receipt of CGA were more likely to be alive and in their own homes at up to six months 15/16, 94% day
Readmissions_in_frail_older_people_SC%203.2.15.docx