Table 2 Summary of reviews on readmissions Paper Author and Description of study Type of Main findings for CASP date review readmissions score published Paper Author Description of Type of Results CASP intervention review score Risk factors for Systematic review of Systematic Need for increased 12/14, hospital L, 12 prospective review vigilance of older people 86% readmission in 2011[] cohort studies with previous hospital elderly patients: (13,183 patients) in admission, long length a systematic people aged 75 of stay, comorbidities review years or more to and functional status identify risk factors for readmission Evidence based Preyde M, Systematic review of Narrative Paucity of published 7/14, risk factors for 2011[] 43 research articles literature research 50% adverse health to ascertain risk review Most commonly outcomes in factors for adverse mentioned risk factors older patients outcomes for older were depression, poor after discharge people discharged cognition, number of home and from acute care comorbidities, length of assessment facilities. Also to stay, prior hospital tools evaluate admission, functional risk status, patient age, assessment tools multiple medications and lack of social support people at risk of adverse outcome discharge may benefit from comprehensive planning Discharge Shepperd S, Meta-analysis of 24 Meta - Significant reduction in 14/16, planning from 2013[] RCTs (8098 patients) analysis readmission rate (RR 88% hospital to 16 of RCT 0.82, 95% CI 0.73 to – home exclusively recruited 0.92) older people in (Cochrane In addition significant mixed medical & review) impact on length of stay surgical settings No impact on mortality Explores effectiveness of Little evidence on cost discharge planning vs non specialised care’ ‘usual
Table 2 Summary of reviews on readmissions Paper Author and date published Description of study Type of review Main findings for readmissions CASP score Paper Author Description of intervention Type of review Results CASP score Risk factors for hospital readmission in elderly patients: a systematic review L, 2011[] Systematic review of 12 prospective cohort studies (13,183 patients) in people aged 75 years or more to identify risk factors for readmission Systematic review Need for increased vigilance of older people with previous hospital admission, long length of stay, comorbidities and functional status 12/14, 86% Evidence based risk factors for adverse health outcomes in older patients after discharge home and assessment tools Preyde M, 2011[] Systematic review of 43 research articles to ascertain risk factors for adverse outcomes for older people discharged from acute care facilities. Also to evaluate risk assessment tools Narrative literature review Paucity of published research Most commonly mentioned risk factors were depression, poor cognition, number of comorbidities, length of stay, prior hospital admission, functional status, patient age, multiple medications and lack of social support people at risk of adverse outcome may benefit from comprehensive discharge planning 7/14, 50% Discharge planning from hospital to home (Cochrane review) Shepperd S, 2013[] Meta-analysis of 24 RCTs (8098 patients) – 16 of RCT exclusively recruited older people in mixed medical & surgical settings Explores effectiveness of discharge planning vs non specialised ‘usual care’ Meta - analysis Significant reduction in readmission rate (RR 0.82, 95% CI 0.73 to 0.92) In addition significant impact on length of stay No impact on mortality Little evidence on cost 14/16, 88%
Readmissions_in_frail_older_people_SC%203.2.15.docx