外科人群中的过渡性护理干预与医院再入院：一项系统综述
Transitional care interventions and hospital readmissions in surgical populations: a systematic review.
作者信息
Jones Caroline E, Hollis Robert H, Wahl Tyler S, Oriel Brad S, Itani Kamal M F, Morris Melanie S, Hawn Mary T
机构信息
University of Alabama-Birmingham, Department of Surgery; Birmingham Veterans Administration Hospital, Birmingham, AL.
VA Boston Health Care System and Tufts University School of Medicine, Department of Surgery, Boston, MA.
出版信息
Am J Surg. 2016 Aug;212(2):327-35. doi: 10.1016/j.amjsurg.2016.04.004. Epub 2016 Jun 1.
BACKGROUND
Despite hospital readmission being a targeted quality metric, few studies have focused on the surgical patient population. We performed a systematic review of transitional care interventions and their effect on hospital readmissions after surgery.
DATA SOURCES
PubMed was searched for studies evaluating transitional care interventions in surgical populations within the years 1995 to 2015. Of 3,527 abstracts identified, 3 randomized controlled trials and 7 observational cohort studies met inclusion criteria.
CONCLUSIONS
Discharge planning programs reduced readmissions by 11.5% (P = .001), 12.5% (P = .04), and 23% (P = .26). Patient education interventions reduced readmissions by 14% (P = .28) and 23.5% (P < .05). Primary care follow-up reduced readmissions by 8.3% for patients after high-risk surgeries (P < .001). Home visits reduced readmissions by 7.69% (P = .023) and 4% (P = .161), respectively. Therefore, improving discharge planning, patient education, and follow-up communication may reduce readmissions.
背景
尽管医院再入院率是一个目标质量指标，但很少有研究关注外科手术患者群体。我们对过渡性护理干预措施及其对手术后医院再入院率的影响进行了系统评价。
数据来源
检索了PubMed中1995年至2015年间评估外科手术人群过渡性护理干预措施的研究。在识别出的3527篇摘要中，有3项随机对照试验和7项观察性队列研究符合纳入标准。
结论
出院计划项目使再入院率分别降低了11.5%（P = .001）、12.5%（P = .04）和23%（P = .26）。患者教育干预措施使再入院率分别降低了14%（P = .28）和23.5%（P < .05）。高危手术后患者接受初级保健随访可使再入院率降低8.3%（P < .001）。家访分别使再入院率降低了7.69%（P = .023）和4%（P = .161）。因此，改善出院计划、患者教育和随访沟通可能会降低再入院率。
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