The Efficacy of Written Information Intervention in Reduction of Hospital Re-admission Cost in Patients With Heart Failure; A Systematic Review and Meta-Analysis

Abstract

Objective: To assess the efficacy of written information versus non written information intervention in reducing hospital readmission cost, if prescribed or presented to the patients with HF. Methods: The study was a systematic review and meta-analysis. We searched Medline (Ovid) and Cochrane library during the past 20 years from 1993 to 2013. We also conducted a manual search through Google Scholar and a direct search in the group of related journals in Black Well and Science Direct trough their websites. Two reviewers appraised the identified studies, and meta-analysis was done to estimate the mean saving cost of patient readmission. All the included studies must have been done by randomization to be eligible for study. Result: We assessed the full-texts 3 out of 65 studies with 754 patients and average age of 74.33. The mean of estimated saving readmission cost in intervention group versus control group was US $2751 (95% CI: 2708 – 2794) and the mean of total saving cost in intervention group versus control group was US $2047 (base year 2010) with (95% CI: 2004 – 2089). No publication bias was found by testing the heterogeneity of studies. Conclusion: One of the effective factors in minimizing the healthcare cost and preventing from hospital re-admission is providing the patients with information prescription in a written format. It is suggested that hospital management, Medicare organizations, policy makers and individual physicians consider the prescription of appropriate medical information as the indispensable part of patient’s care process.

Interventions to assist pet owners in online health information seeking behaviour: a qualitative content analysis literature review and proposed model

“… Primary outcomes: Instrumental outcomes ○Pet health information evaluation skill (gain ability to search/evaluate/appraise/apply online pet health information e.g. ability to discriminate between different quality websites) (Diviani et al., ; Lee et al., ; Solhjoo, ; Witman, ) ○Self‐efficacy for online pet health information seeking (belief in one's ability to seek online information and use Internet) (Burke et al., ; D'alessandro, Kreiter, Kinzer, & Peterson, ; Diviani et al., ; Kogan, Schoenfeld‐Tacher, Gould, Viera, et al., ; Kogan, Schoenfeld‐Tacher, Gould, Hellyer, et al., ; Lee et al., ) Communication outcomes ○Vet–client communication enhancement (increase in communication with veterinarian about online pet health information) (Chesser, Woods, Davis, & Bowers, ; Kogan, Schoenfeld‐Tacher, Gould, Viera, et al., ; Kogan, Schoenfeld‐Tacher, Gould, Hellyer, et al., ; Solhjoo, ) ○Family/friend involvement (communicate and discuss with family/friend about online pet health information) (Kogan, Schoenfeld‐Tacher, Gould, Viera, et al., ; Kogan, Schoenfeld‐Tacher, Gould, Hellyer, et al., ; Solhjoo, ) Satisfaction ○Pet owner satisfaction with the information intervention/information provided (Chesser et al., ; D'alessandro et al., ; Gavgani, Majd, Nosratnejad, Golmohammadi, & Sadeghi‐Bazargani, ; Kogan, Schoenfeld‐Tacher, Gould, Viera, et al., ; Kogan, Schoenfeld‐Tacher, Gould, Hellyer, et al., ) Secondary outcomes: Learning outcomes ○Knowledge acquisition (level of knowledge or increase in knowledge about pet health status, pet's disease, procedure or treatment) (Car et al., ; Solhjoo, ) ○Skills acquisition (changes in pet owner's health behaviour or enhance pet's lifestyle) (Car et al., ; Solhjoo, ) Health outcomes ○Pet health status and well‐being (changes in pet's physical health and biometric markers e.g.) (Lee et al., ) Economic outcomes ○Costs of pet health care (e.g.…”

“…costs of in‐patient care, costs of home‐care) ○Cost of discharge planning (e.g. to hospital and community) (Gavgani et al., ). …”

“…• Instrumental outcomes ○ Pet health information evaluation skill (gain ability to search/evaluate/appraise/ apply online pet health information e.g. ability to discriminate between different quality websites) (Diviani et al, 2015;Lee et al, 2014;Solhjoo, 2018;Witman, 2017) ○ Self-efficacy for online pet health information seeking (belief in one's ability to seek online information and use Internet) (Burke et al, 2010;D'alessandro, Kreiter, Kinzer, & Peterson, 2004;Diviani et al, 2015;Kogan, Schoenfeld-Tacher, Gould, Viera, et al, 2014;Lee et al, 2014) • Communication outcomes ○ Vet-client communication enhancement (increase in communication with veterinarian about online pet health information) (Chesser, Woods, Davis, & Bowers, 2012;Kogan, Schoenfeld-Tacher, Gould, Viera, et al, 2014;Solhjoo, 2018) ○ Family/friend involvement (communicate and discuss with family/friend about online pet health information) (Kogan, Schoenfeld-Tacher, Gould, Viera, et al, 2014;Solhjoo, 2018) • Satisfaction ○ Pet owner satisfaction with the information intervention/information provided (Chesser et al, 2012;D'alessandro et al, 2004;Gavgani, Majd, Nosratnejad, Golmohammadi, & Sadeghi-Bazargani, 2015;Kogan, Schoenfeld-Tacher, Gould, Viera, et al, 2014;) 2 Secondary outcomes:…”

Economic Evaluation of Quality Improvement Interventions Designed to Prevent Hospital Readmission

“…Searches were restricted to English-language documents from January 2004 to July 2016. We hand-searched citations from previous systematic reviews and other sources …”

Implementation of interventions to reduce preventable hospital admissions for cardiovascular or respiratory conditions: an evidence map and realist synthesis

“…Some commentators have suggested the value of the 'information prescription', analogous to a medication prescription, which combines a formality of exchange with personalisation to patient perspectives. 35 In connection with tailoring, a review by the Joanna Briggs Institute 34 suggests that future studies might consider interventions inclusive of more diverse ethnic populations of varying literacy and socioeconomic levels.…”