Early supported discharge for older adults admitted to hospital with medical complaints: a systematic review and meta-analysis
Introduction: Early supported discharge (ESD) aims to link acute and community care, allowing hospital inpatients to return home and continue to receive the necessary input from healthcare professionals that they would other‑ wise receive in hospital. The concept has shown reduced length of stay and improved functional outcomes in stroke patients. This systematic review aims to explore the totality of evidence for the use of early supported discharge in older adults hospitalised with medical complaints.
Methods: A literature search of CINAHL in EBSCO, Cochrane Central Register of Controlled Trials in the Cochrane Library (CENTRAL), EMBASE and MEDLINE in EBSCO was carried out. Randomised controlled trials or quasi-randomised controlled trials were included. The Cochrane Risk of Bias Tool 2.0 was used for quality assessment. The primary out‑ come measure was hospital length of stay. Secondary outcomes included mortality, function, health related quality of life, hospital readmissions, long-term care admissions and cognition. A pooled meta-analysis was conducted using RevMan software 5.4.1.
Results: Five studies met the inclusion criteria. All studies were of some concern in terms of their risk of bias. Statisti‑ cally signifcant efects favouring ESD interventions were only seen in terms of length of stay (REM, MD= -6.04, 95% CI -9.76 to -2.32, I 2=90%, P=0.001). No statistically signifcant efects favouring ESD interventions were established in secondary outcomes.
Conclusion: ESD interventions can have a statistically signifcant impact on the length of stay of older adults admit‑ ted to hospital for medical reasons. There is a need for further higher quality research in the area, with standardised interventions and outcome measures used.
PublicationBMC Geriatrics, 22, 302
Department or School
- Allied Health
- School of Medicine