Abstract
Study with the objective of analysing the evidence available in the scientific literature on the interventions used to reduce hospital readmissions within 30 days in clinical patients who were discharged from the hospital to the home. An integrative review was carried out on the online Medical Literature Analysis and Retrieval System and Latin American and Caribbean Literature in Health Sciences databases. Intervention research, published between January 2009 and April 2020, in Portuguese, English and Spanish, was included. The sample consisted of 71 articles. The most frequently performed interventions were telephone contact after discharge (73.2%), health education after discharge (71.8%) and health education during hospitalization (67.6%). Identification of readmission risk (12.9%), home visits after discharge (26.8%) and discharge planning (28.2%) were the least mentioned. The interventions were performed predominantly by a multidisciplinary team (39.5%). There was a significant reduction in readmissions in 50.7% of the studies. It was found that the interventions are aimed at preparing the patient during hospitalization for the return home and post-discharge monitoring to reinforce the care plans and clarify doubts, this important combination of different actions by the multiprofessional team impacts readmission rates.
Highlights
Rate of hospital readmission has been considered an indicator of quality of health care (Neta et al, 2017, Tavares et al., 2020)
The following review question was elaborated: What is the scientific evidence on health interventions used to reduce hospital readmission within 30 days in clinical patients who were discharged from the hospital to their homes?
A combination of the following Medical Subject Headings (MeSH) descriptors was used as search strategy: ("readmission" OR "hospital readmission" OR "patient readmission" OR "unplanned readmission*" OR "30 day readmission" OR "re‐admission" OR "re‐admit*") AND (“discharge planning” OR “patient discharge” OR “patient transfer” OR “care transition” OR “care transitions” OR “transition of care” OR “transitional care” OR "continuity of care” OR "follow-up" OR “patient education” OR “medication reconciliation” OR "communication" OR "patient care team") AND NOT
Summary
Rate of hospital readmission has been considered an indicator of quality of health care (Neta et al, 2017, Tavares et al., 2020). It measures how many patients are readmitted to the hospital after they have been discharged. A number of studies indicate that hospital readmission is influenced by individual and organizational factors that can be related to the care provided from admission to post-discharge (Tavares et al, 2020, Fischer et al, 2012). The organizational factors include inadequate management of the comorbidities during hospitalization, errors in medication use, and failures in communication and in the post-discharge followup (Wiegmann et al, 2020)
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