Meta-analysis of case management model in reducing the rehospitalization rate of patients with chronic heart failure

Abstract

Objective To systematically review the efficiency of community case management in reducing the rehospitalization rate and hospitalization time, and shortening the hospitalization costs of patients with chronic heart failure (CHD) . Methods Randomized controlled trials (RCTs) and clinical control trials (CCTs) of community case management about the number of hospitalized patients and the average hospitalization time were collected from Cochrane library, JBI evidence-based nursing center library, MEDLINE, Embase, Pubmed, CNKI, VIP, and Wanfang. Data were searched and extracted; captured citations were screened; and the methodological quality of all included studies was assessed by 2 reviewers independently. Revman 5.3 software was used to perform the meta-analysis. Results Totally 14 published studies were included in the systematic review, and they were all RCTs. The results of meta-analysis showed that, compared with patients without community case management, there was statistically significant difference in the effects of case management on the rehospitalization rate and hospitalization time of CHD patients [random effects model OR=0.76, 95%CI (0.65, 0.88) , P<0.01] [random effects model OR=-1.23, 95%CI (-1.58, -0.88) , P<0.01]. Conclusions Community case management can effectively reduce the rehospitalization rate and shorten the hospitalization time of CHD patients, so it is worth being popularized. Key words: Heart failure; Meta-analysis; Case management model; Rehospitalization rate