同步出院后联系对医疗保健使用和患者满意度的有效性:系统性审查和元分析
Joel C Boggan1, Spoorthi Sankineni2, Paul A Dennis3
1Hospital Medicine Section, Medical Service, Durham Veterans Affairs Health Care System, and Division of Hospital Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina (J.C.B.).
Annals of internal medicine
|January 13, 2025
概括
医院出院7天内的出院后接触者 (PDC) 并没有减少急诊室的访问或再入院. 卫生系统应该专注于针对高风险患者的有针对性的干预措施,而不是普遍的PDC.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床有效性研究研究 临床有效性研究
- 患者的治疗结果.
背景情况:
- 退院后接触 (PDC) 是住院后的一种常见策略.
- PDCs在减少急性护理利用率方面的有效性仍然不确定.
研究的目的:
- 评估PDCs对30天急诊室 (ED) 访问和医院再入院的影响.
- 评估PDCs对患者满意度的影响.
主要方法:
- 对PDCs随机和非随机试验进行系统审查和元分析,在出院后7天内完成.
- 从2012年到2023年5月,在MEDLINE,Embase和CINAHL进行了搜索.
- 使用GRADE框架评估偏见风险和证据确定性.
主要成果:
- 包括13项研究 (11项随机试验),主要涉及电话联系.
- 在30天的ED使用 (5次RT) 或30天的医院再入院 (7次RT) 与PDCs没有发现显著差异.
- 对这两种结果的证据中等确定性.
结论:
- 释放后7天内的PDC与30天ED使用或再录取的减少无关.
- 全面性PDC可能不有效;对于高风险患者,可能需要多方面的干预措施来减少急性护理利用率.
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