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 otherwise receive in hospital. It has been researched extensively in the stroke p...

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Main Authors: Susan Williams (Author), Ann-Marie Morrissey (Author), Fiona Steed (Author), Aoife Leahy (Author), Elaine Shanahan (Author), Catherine Peters (Author), Margaret O’Connor (Author), Rose Galvin (Author), Clíona O'Riordan (Author)
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Published: James Cook University, 2023-01-01T00:00:00Z.
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042 |a dc 
100 1 0 |a Susan Williams  |e author 
700 1 0 |a Ann-Marie Morrissey  |e author 
700 1 0 |a Fiona Steed  |e author 
700 1 0 |a Aoife Leahy  |e author 
700 1 0 |a Elaine Shanahan  |e author 
700 1 0 |a Catherine Peters  |e author 
700 1 0 |a Margaret O’Connor  |e author 
700 1 0 |a Rose Galvin  |e author 
700 1 0 |a Clíona O'Riordan  |e author 
245 0 0 |a Early supported discharge for older adults admitted to hospital with medical complaints: a systematic review and meta-analysis 
260 |b James Cook University,   |c 2023-01-01T00:00:00Z. 
500 |a 10.22605/RRH8155 
500 |a 1445-6354 
520 |a 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 otherwise receive in hospital. It has been researched extensively in the stroke population, showing reduced length of stay for patients and improved functional outcomes. This systematic review aims to explore the totality of evidence for the use of ESD in an older adult population who have been hospitalised with medical complaints.Methods: Systematic searches were conducted in MEDLINE, CINAHL, Ebsco, Cochrane Library and EMBASE. Randomised controlled trials (RCTs) and quasi-RCTs were included if they provided an ESD intervention to older adults admitted to hospital for medical complaints compared with usual inpatient care. Patient and process outcomes were explored. The Cochrane Risk of Bias Tool was used to assess methodological quality. A meta-analysis was conducted using RevMan 5.4.1.Results: Five RCTs met the inclusion criteria. The quality of the trials was mixed overall, with high levels of heterogeneity. ESD demonstrated a statistically significant reduction in length of stay (MD -6.04 days, 95% CI -9.76 to -2.32) and improvements in function, cognition, and health-related quality of life, with no increased risk of long-term care admission, hospital re-admission or mortality in the ESD interventions versus usual care groups.Discussion: This review demonstrates that ESD positively impacts patient and process outcomes for older adults. Further consideration should be given to exploring the experiences of those involved in ESD including older adults, family members/caregivers as well as healthcare professionals. 
546 |a EN 
690 |a Special situations and conditions 
690 |a RC952-1245 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n Rural and Remote Health, Vol 23 (2023) 
787 0 |n https://www.rrh.org.au/journal/article/8155/ 
787 0 |n https://doaj.org/toc/1445-6354 
856 4 1 |u https://doaj.org/article/1c8b45f377f54ac6b3fcedf3c90a56ab  |z Connect to this object online.