Key result
A broad range of integrated interventions across hospital and community settings may be effective in reducing unnecessary use of acute hospital beds by frail older people.
Why the study?
Do integrated interventions across hospital and community settings reduce hospital admissions and length of stay in frail older people?
Systematic Review (n=48)
Do integrated interventions across hospital and community settings reduce hospital admissions and length of stay in frail older people?
Reducing unnecessary hospital bed use by frail older people requires an integrated approach across hospital and community settings, utilizing a broad range of effective interventions.
Supports integrated interventions to curb unnecessary acute bed use in frail older adults; extends evidence across hospital-community settings.
INTRODUCTION: Numerous studies have been conducted in developed countries to evaluate the impact of interventions designed to reduce hospital admissions or length of stay (LOS) amongst frail older people. In this study, we have undertaken a systematic review of the recent international literature (2007-present) to help improve our understanding about the impact of these interventions. METHODS: WE SYSTEMATICALLY SEARCHED THE FOLLOWING DATABASES: PubMed/Medline, PsycINFO, CINAHL, BioMed Central and Kings Fund library. Studies were limited to publications from the period 2007-present and a total of 514 studies were identified. RESULTS: A total of 48 studies were included for full review consisting of 11 meta-analyses, 9 systematic reviews, 5 structured literature reviews, 8 randomised controlled trials and 15 other studies. We classified interventions into those which aimed to prevent admission, interventions in hospital, and those which aimed to support early discharge. CONCLUSIONS: Reducing unnecessary use of acute hospital beds by older people requires an integrated approach across hospital and community settings. A stronger evidence base has emerged in recent years about a broad range of interventions which may be effective. Local agencies need to work together to implement these interventions to create a sustainable health care system for older people.
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Philp et al. (2013) conducted a systematic review in Frail older people at risk of hospital admission or prolonged length of stay (n=48). Integrated hospital and community interventions vs. Usual care was evaluated on Hospital admissions or length of stay. A broad range of integrated interventions across hospital and community settings may be effective in reducing unnecessary use of acute hospital beds by frail older people.
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