Interventions to Promote Early Discharge and Avoid Inappropriate Hospital (Re)Admission: A Systematic Review.

Area of Science:

• Healthcare Management
• Health Services Research
• Patient Discharge Studies

Background:

• Limited healthcare resources necessitate strategies for early hospital discharge and prevention of inappropriate readmissions.
• Systematic reviews are vital for evaluating interventions aimed at optimizing patient flow and resource allocation in acute care settings.

Purpose of the Study:

• To systematically review evidence on interventions promoting early discharge and preventing inappropriate hospital readmissions.
• To categorize and assess the effectiveness of various discharge interventions delivered in acute care hospitals and post-acute settings.

Main Methods:

• A systematic review of academic electronic databases from 2005 to 2018.
• Inclusion of ninety-four eligible papers, categorizing interventions into pre-discharge, pre- and post-discharge, post-discharge at home, and post-acute facility delivery.
• Analysis of intervention effectiveness in relation to hospital (re)admission rates and discharge timing.

Main Results:

• Mixed effectiveness was observed across various interventions; pre-discharge and education-focused interventions showed limited success in preventing readmissions.
• Successful interventions involved multidisciplinary teams, integrated hospital-community care, and individualized patient services.
• Post-discharge interventions at home reduced hospital stay and increased patient satisfaction, while telehealth and long-term care showed insufficient evidence for admission avoidance.

Conclusions:

• Integrated systems between hospitals and community care, alongside multidisciplinary service provision, are key to successful early discharge and readmission prevention.
• Individualized discharge planning initiated during hospitalization and specialist follow-up are critical components of effective interventions.
• Further research may be needed to optimize telehealth and long-term care interventions for admission avoidance.