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July 6, 2013BMC GeriatricsOpen Access

Effectiveness of early discharge planning in acutely ill or injured hospitalized older adults: a systematic review and meta-analysis

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Why the study?

Does early discharge planning reduce hospital readmissions and length of stay in acutely ill or injured hospitalized older adults?

Population

1,736 older adults admitted to hospital with an acute illness or injury (pooled from 9 trials)

Comparison

Early discharge planning vs Usual care

Design

Meta-analysis

Follow-up

1 to 12 months

Authors

MFMary FoxMPMalini PersaudIMIlo Maimets

Discussion

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Overview

Supports early discharge planning in older adults; extends Level 1 evidence for fewer readmissions and shorter readmission stays.

Key Points

  • To assess the effectiveness of early discharge planning compared to usual care on hospital stay lengths, readmission rates, mortality, patient satisfaction, and quality of life in acutely ill or injured older adults.
  • Searched electronic databases including Cochrane, MEDLINE, EMBASE, and CINAHL alongside gerontological journals and grey literature.
  • Extracted data from 9 comparative trials comprising 1736 acutely admitted older participants, using random-effects meta-analysis and narrative synthesis.
  • Early discharge planning reduced hospital readmissions within 1 to 12 months post-discharge (RR = 0.78, 95% CI = 0.69 - 0.90).
  • Readmission length of hospital stay was lower between 3 and 12 months post-discharge (WMD = -2.47 days, 95% CI = -4.13 - -0.81).
  • No differences were observed for index length of hospital stay, mortality, or discharge planning satisfaction, though narrative analysis showed improved quality of life at two weeks.

Structured PICO

Does early discharge planning reduce hospital readmissions and length of stay in acutely ill or injured hospitalized older adults?

P
Population
1,736 older adults admitted to hospital with an acute illness or injury (pooled from 9 trials)
I
Intervention
Early discharge planning
C
Comparator
Usual care
O
Outcome
Index length of hospital stay, hospital readmissions, readmission length of hospital stay, and mortalityhard clinical

Early discharge planning for acutely admitted older adults significantly reduces subsequent hospital readmissions and readmission length of stay.

Cite This Study

Fox et al. (2013) studied this question.

synapsesocial.com/papers/6a759eefef3d015f2ddd7e68https://doi.org/10.1186/1471-2318-13-70
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Discharge Planning From Hospital to Home for Elderly Patients: A Meta-Analysis2009 · 54 citations
  2. 2A New Multimodal Geriatric Discharge‐Planning Intervention to Prevent Emergency Visits and Rehospitalizations of Older Adults: The Optimization of Medication in <scp>AGE</scp> d Multicenter Randomized Controlled Trial2011 · 136 citations
  3. 3Interventions to Reduce 30-Day Rehospitalization: A Systematic Review2011 · 1,209 citations
  4. 4Improving Patient Handovers From Hospital to Primary Care2012 · 368 citations
  5. 5Quantitative Synthesis in Systematic Reviews1997 · 2,523 citations