Risk factors for acute care hospital readmission in persons aged 60 and over from western countries: a systematic review protocol

Abstract

Review question/objective The objective of this systematic review is to identify and synthesize the best available evidence on risk factors for acute care hospital readmission in older people. More specifically, the review question is: What are the main risk factors for acute care hospital readmission within one month of discharge in people aged 60 years or older from western countries? Inclusion criteria Types of participants This systematic review will consider studies that include participants of both sexes, aged 60 years or older from western countries, who have been admitted to hospital as an in-patient, discharged to their homes or to residential care facilities and readmitted to an acute care hospital within one month. One month is defined as a period ranking between immediate after discharge until 28-31 days after discharge. . The age limit of 60+ has been chosen as the criterion for a person being considered as old and only studies where it is possible to identify participants were aged 60 or more will be included. Western countries cover the following areas: North America (USA and Canada), Australia, New Zealand and Europe. Studies on persons who are readmitted to hospital for palliative or psychiatric care and/or discharged from psychiatric of palliative wards will be excluded, as well as studies on persons readmitted for elective treatment. Phenomena of interest The phenomenon of interest in this review is the risk factors for hospital readmission within one month of discharge in western countries. Risk factors in this review consider non-modifiable risk markers such as demographics (age, sex, ethnicity) and modifiable risk factors, such as socioeconomics (income, education, civic status, social support), health/illness (medication, diagnosis, comorbidity, functional and cognitive capability), health care utilization (emergency room visits, out-patient department visits, GP visits) and pathway-related factors (length of stay, medical specialties involved, need for intensive care treatment).26 Studies focusing on specific treatments or diagnoses will be excluded. Types of outcomes The primary outcome of interest is readmission of older persons to an acute care hospital within one month of discharge from a former hospital admission. Studies that do not report on the outcome of interest as a primary or secondary outcome and at a time interval within one month will be excluded. Subgroup analyses will be conducted for studies investigating hospital readmission within shorter time intervals than one month.