Discharge Planning From Hospital to Home for Elderly Patients: A Meta-Analysis

Abstract

In the present healthcare environment, budget cuts, staff shortages, and resource limitations are grave concerns. The elderly in particular consume a considerable proportion of hospital resources. Thus, the discharge planner's role, particularly with respect to elderly patients, is extremely important. In this systematic review recent (within the last 10 years) randomized, controlled or quasi-experimental trials of discharge planning (DP) from hospital to home of patients age 65 years or older were examined. The most important finding was the paucity of investigations by social work professionals. A second important finding was the lack of appropriate reporting of methods and results. Where data were provided, an effect size was computed for statistically significant results (overall mean d = 0.51, SD 0.35). Large effects were noted for patient satisfaction, while moderate effects were evident for patients' quality of life and readmission rates. The integration and evaluation of current knowledge in this field may inform further research and may lead to the advancement of clinical practice and new policy development, with the ultimate goal of improving the quality of patient care and the quality of patient outcomes. The implications for social work clinicians and researchers are discussed.

Discharge Planning for the Elderly in Acute Care: The Perceptions of Experienced Occupational Therapists

“…Discharge planning for seniors consumes a significant percentage of both hospital and community resources to coordinate the person's ongoing medical and rehabilitation care needs and to arrange the frequently needed support of family members or other caregivers after discharge (Popejoy, 2011a;Preyde, Macaulay, & Dingwall, 2009). This complex process involves multiple parties with various agendas and cannot always accommodate the self-determination and self-advocacy of a person's wants and needs (Foss & Hofoss, 2011;Popejoy, 2011b;Popejoy, Moylan, & Galambos, 2009;Williams, Nolan, & Keady, 2009).…”

Hospital to Community Transitions for Adults: Discharge Planners and Community Service Providers’ Perspectives

“…These include high workloads of discharge planners (Bowles, Naylor, & Foust, 2002;Watts, Pierson, & Gardner, 2006), lack of trained personnel (Bowles et al 2003), ineffective communication between discharge planners, community-based providers, and/or physicians (Preyde, Macaulay, & Dingwall, 2009;Dill, 1995;Mamon et al, 1992;Minichello, Auerbach, & Wachter, 2001;Payne et al, 2002), family conflict (Bowles et al, 2002;LeClerc, Wells, Craig, Wilson, & Dellasega, 2002;Tennier, 1997), and ethical tensions between patient autonomy and safety (Dill, 1995). Other studies also identify poor timing as a critical barrier to effective discharge planning processes (Hegney et al 2002).…”

Interventions to Reduce Rehospitalizations after Chronic Obstructive Pulmonary Disease Exacerbations. A Systematic Review

“…Previous reviews on care transitions from hospital to home have focused on other patient populations (ie, not patients with COPD exacerbations) (20)(21)(22). However, no review to date has focused specifically on identifying interventions that reduce rehospitalizations in patients hospitalized for COPD exacerbations.…”