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Abstract
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. 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. 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. 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.
Highlights
Numerous studies have been conducted in developed countries to evaluate the impact of interventions designed to reduce hospital admissions or length of stay amongst frail older people
There is an emerging consensus about the definition of frailty in older people and its association with increased hospital admissions due to falls, confusion and loss of mobility and with increased length of stay once admitted to hospital [1]
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 (6 before and after studies, 6 non-randomised controlled trials, 1 comparator group study, 1 cohort study with case controls and 1 observational cohort study)
Summary
Numerous studies have been conducted in developed countries to evaluate the impact of interventions designed to reduce hospital admissions or length of stay amongst frail older people. We have undertaken a systematic review of the recent international literature (2007-present) to help improve our understanding about the impact of these interventions. Conclusions: Reducing unnecessary use of acute hospital beds by older people requires an integrated approach across hospital and community settings. There is an emerging consensus about the definition of frailty in older people and its association with increased hospital admissions due to falls, confusion and loss of mobility and with increased length of stay once admitted to hospital [1]. Impact Outcomes [3] Systematic review (M) Systematic reviewof interventions intended to reduce admission to hospital of older people. The review had some methodological limitations and caution is warranted when interpreting the author's conclusions
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