Get access

Interventions to reduce hospital readmissions in the elderly: in-hospital or home care. A systematic review

Authors

  • Renata Linertová Ba Econ,

    Corresponding author
    1. Research Fellow, Canary Islands Foundation for Health and Research (FUNCIS), Santa Cruz de Tenerife, Spain
    Search for more papers by this author
  • Lidia García-Pérez MMR,

    1. Research Fellow, Canary Islands Foundation for Health and Research (FUNCIS), Santa Cruz de Tenerife, Spain and Research Fellow, CIBER Epidemiología y Salud Pública (CIBERESP), Spain
    Search for more papers by this author
  • José Ramón Vázquez-Díaz MD PhD,

    1. Doctor, Unit of Family and Community Medicine ‘La Laguna – Tenerife North’, University Hospital of Canary Islands, La Laguna, Spain
    Search for more papers by this author
  • Antonio Lorenzo-Riera MD PhD,

    1. Doctor, Primary Care Services of Gran Canaria, Las Palmas de Gran Canaria, Spain
    Search for more papers by this author
  • Antonio Sarría-Santamera MD PhD

    1. Director, Agency for Health Technology Assessment, Carlos III Institute of Health, Madrid, Spain and Professor, Department of Health Sciences and Social Medicine, University of Alcalá, Madrid, Spain
    Search for more papers by this author

  • The work was carried out in Health Service of Canary Islands, Department of Planning and Evaluation, Spain (same address as the corresponding author).

Ms Renata Linertová, Department of Planning and Evaluation, Health Service of Canary Islands, C/Pérez de Rozas, n°5, 4a planta, 38004 Santa Cruz de Tenerife, Canary Islands, Spain, E-mail: renata.linertova@sescs.es

Abstract

Rationale, aims and objectives  Unplanned hospital readmissions of elderly people represent an increasing burden on health care systems. This burden could theoretically be reduced by adequate preventive interventions, although there is uncertainty about the effectiveness of different types of interventions. The objective of this systematic review was to identify interventions that effectively reduce the risk of hospital readmissions in patients of 75 years and older, and to assess the role of home follow-up.

Methods  We searched studies in MEDLINE, CINAHL, CENTRAL and seven other electronic databases up to October 2007, and we updated the MEDLINE search in October 2009. Clinical trials (randomized or controlled) evaluating the effectiveness of an intervention aimed at reducing readmissions in elderly patients were selected. Quality was assessed using the SIGN tool and the information extracted is presented in text and tables.

Results  Thirty-two clinical trials were included and they were divided into two groups: in-hospital interventions (17 studies) and interventions with home follow-up (15 studies). A positive effect of the intervention evaluated on the readmission outcome was found in three studies from the first group and in seven from the second group.

Conclusions  Most of the interventions evaluated did not have any effect on the readmission of elderly patients. However, those interventions that included home care components seem to be more likely to reduce readmissions in the elderly.

Ancillary