Reducing hospital bed use by frail older people: results from a systematic review of the literature
DOI:
https://doi.org/10.5334/ijic.1148Keywords:
older people, hospital bed use, admissions avoidance,Abstract
Introduction
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. 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.
Methods
We systematically searched the following databases: PubMed / Medline, PsycINFO, CINAHL, BioMed Central, Kings Fund library. Studies were limited to publications from the period 2007-present and a total of 514 studies were identified.
Results
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.
Conclusions
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 healthcare system for older people.
Published
Issue
Section
License
Copyright (c) 2013 The Author(s)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors
Starting in 2009 the International Journal of Integrated Care applies the Creative Commons Attribution 4.0 Internaltional License (CC-BY, http://creativecommons.org/licenses/by/4.0/) to all articles, submitted in or after January 2009, that are published in IJIC. Authors retain ownership of the copyright for their articles, but they permit anyone unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. After it has appeared in IJIC authors may republish their text in any way they wish (electronic or print) as long as they clearly acknowledge IJIC as its original publisher with the correct citation details and copyright notice, independent of whether the article is used in whole or in part.
- Authors of accepted manuscripts assign IJIC the right to publish and distribute their text electronically and to archive it permanently retrievable electronically.
- Authors retain the copyright of the article. After it has appeared in IJIC authors may republish their text in any way they wish (electronic or print) as long as they clearly acknowledge IJIC as its original publisher with the correct citation details and copyright notice (see below), independent whether the article is used in whole or in part.
- IJIC may change the appearance of the article, both layout and technical format, to ensure consistency and readability. Under no circumstance will the content of the article be altered.
- The author warrants to IJIC that the article is original, does not infringe any existing copyright, and does not infringe the rights of any third party. This warrant concerns the entire manuscript, text as well as pictures, sound, video, data sets etc. The author also warrants to us that he has full authority to enter into this agreement and that the rights he is granting to IJIC are done so without breaching any obligations he may have.
- Acceptation:
Readers
Starting 2009 Utrecht the International Journal of Integrated Care applies the Creative Commons Attribution 4.0 International License (CC-by) to all articles, submitted in or after January 2009, that are published in the IJIC. Under the CC-by, authors retain ownership of the copyright for their article, but authors allow anyone unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. No permission is required from the authors or the publishers.
- Persons using http://www.ijic.org may view, reproduce or store copies of articles of the journal provided that they are used only for their personal, non-commercial use (especially for educational purposes). Articles with the CC-by logo are published under the CC-by license and can be used without restrictions, provided the article is properly cited. Any uses or copies of this Journal in whole or in part must include the citation details and copyright notice (see below) of IJIC. The URL (= uniform resource locator) of a document in IJIC (from this server) may be used in another electronic document freely.
- Linking: IJIC encourages and appreciates links in your own Web pages to IJIC-webpages. Permission is expressly granted to any person who wishes to place a link in his or her own Web page to IJIC's homepage http://www.ijic.org. As a courtesy, if you link to, or include IJIC in an index, please let us know.
- Privacy statement: On the IJIC site we may collect some anonymous information about you when you visit this site. IJIC may also include information for its own use about your visit in collective or aggregated data that does not identify you specifically.
Citation details and copyright notice
When referring to International Journal of Integrated Care either for re-publication by the author or permitted usage by third parties, the following information should be added:
Citation details:
Customary bibliographic citation, including author name(s), volume number and date of publication, article title, International Journal of Integrated Care (or abbreviation Int J of Integr Care), and the DOI (for instance http://doi.org/10.5334/sta.433).
Copyright notice for papers submitted in or after January 2009: "This work is licensed under a Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited "
Copyright notice for papers submitted in or before 2008:
"Readers are reminded that this work is protected by copyright. While they are free to use the ideas expressed in it, they are not allowed to copy, distribute or publish the work or part of it, in any form, printed, electronic or otherwise, except for reasonable quoting, clearly indicating the source. Readers are permitted to make copies, electronically or printed, for non-commercial use, particularly personal or classroom use."
The authors retain copyright of their article.