Early discharge to therapy-based rehabilitation at home in patients with stroke: a systematic review

2008 ◽  
Vol 13 (3) ◽  
pp. 167-187 ◽  
Author(s):  
Annette Winkel ◽  
Charlotte Ekdahl ◽  
Gunvor Gard
Author(s):  
Coffey ◽  
Leahy-Warren ◽  
Savage ◽  
Hegarty ◽  
Cornally ◽  
...  

Increasing pressure on limited healthcare resources has necessitated the development of measures promoting early discharge and avoiding inappropriate hospital (re)admission. This systematic review examines the evidence for interventions in acute hospitals including (i) hospital-patient discharge to home, community services or other settings, (ii) hospital discharge to another care setting, and (iii) reduction or prevention of inappropriate hospital (re)admissions. Academic electronic databases were searched from 2005 to 2018. In total, ninety-four eligible papers were included. Interventions were categorized into: (1) pre-discharge exclusively delivered in the acute care hospital, (2) pre- and post-discharge delivered by acute care hospital, (3) post-discharge delivered at home and (4) delivered only in a post-acute facility. Mixed results were found regarding the effectiveness of many types of interventions. Interventions exclusively delivered in the acute hospital pre-discharge and those involving education were most common but their effectiveness was limited in avoiding (re)admission. Successful pre- and post-discharge interventions focused on multidisciplinary approaches. Post-discharge interventions exclusively delivered at home reduced hospital stay and contributed to patient satisfaction. Existing systematic reviews on tele-health and long-term care interventions suggest insufficient evidence for admission avoidance. The most effective interventions to avoid inappropriate re-admission to hospital and promote early discharge included integrated systems between hospital and the community care, multidisciplinary service provision, individualization of services, discharge planning initiated in hospital and specialist follow-up.


2021 ◽  
Vol 77 (18) ◽  
pp. 972
Author(s):  
Rahul Gupta ◽  
Sugandhi Mahajan ◽  
Umair Tariq ◽  
Bilal Saqi ◽  
Nikhil Mehta ◽  
...  

2011 ◽  
Vol 41 (4) ◽  
pp. 754-760 ◽  
Author(s):  
Sebastiano Mercadante ◽  
Giampiero Porzio ◽  
Alessandro Valle ◽  
Flavio Fusco ◽  
Federica Aielli ◽  
...  

2017 ◽  
Vol 30 (12) ◽  
pp. 835
Author(s):  
Mariana Alves ◽  
Miguel Bigotte Vieira ◽  
João Costa ◽  
António Vaz Carneiro

Hospital at home is a service that provides active treatment by healthcare professionals in the patient’s home for a condition that otherwise would require acute hospital in-patient care. However, the clinical benefit of this intervention and its effect on health costs are not established. This Cochrane systematic review aimed to assess the effectiveness and costs of managing patients with hospital at home compared with inpatient hospital care. A systematic review of the literature was carried out by searching the following databases to 9 January 2017: Cochrane Effective Practice and Organization of Care Group (EPOC) register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, EconLit and clinical trials registries. Thirty-two randomized trials (2 of which unpublished), including 4746 patients, were included. The present review provides insufficient objective evidence of economic benefit (through a reduction in hospital length of stay) or improved health outcomes.


2019 ◽  
Vol 62 (5) ◽  
pp. 366-378 ◽  
Author(s):  
Anaick Perrochon ◽  
Benoit Borel ◽  
Dan Istrate ◽  
Maxence Compagnat ◽  
Jean-Christophe Daviet

2019 ◽  
Vol 30 (3) ◽  
pp. 285-294 ◽  
Author(s):  
Eveline Claudia Martini ◽  
Sibelli Olivieri Parreiras ◽  
Eric Dario Acuña ◽  
Alessandro Dourado Loguercio ◽  
Alessandra Reis

Abstract To answer the following focused question through a systematic review: “Are the risk and intensity of tooth sensitivity (TS) and bleaching efficacy different between adult patients who undergo at-home bleaching using trays with reservoirs and those who use trays without reservoirs?”. A comprehensive search was performed in the MEDLINE via PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database, Brazilian Library in Dentistry, Cochrane Library, and grey literature without restrictions. Abstracts from conferences; unpublished and ongoing trial registries, dissertations and theses (ProQuest Dissertations and Periódicos Capes Theses databases) were searched. Only randomized clinical trials (RCTs) were included. We used the Risk of Bias tool (RoB) from the Cochrane Collaboration for quality assessment. After the removal of duplicates, title and abstract screening and full-text examination, nine RCTs remained for qualitative analyses. The great majority of the studies did not report the method of randomization, allocation concealment, and examiner blinding during color assessment. From the nine studies, eight were at unclear risk of bias. In regard to color change, four studies reported no change and two reported improved color change with reservoirs. Only four studies recorded tooth sensitivity and they reported no significant differences. Only one study reported greater gingival irritation with reservoirs. Lack of data reporting prevented us from running a meta-analysis. Further well-designed RCT should be conducted to answer this research question. So far there is not evidence to support that reservoirs in bleaching trays improve color change. PROSPERO - CRD42016037628


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