社区居住的老年人群的医疗和社会保健服务是否有助于减少非计划性的二级医疗，支持及时出院并提高患者的幸福感？一项针对系统评价的混合方法元评价。

Does health and social care provision for the community dwelling older population help to reduce unplanned secondary care, support timely discharge and improve patient well-being? A mixed method meta-review of systematic reviews.

机构信息

Centre for Academic Primary Care, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK.

Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK, Newcastle, UK.

出版信息

F1000Res. 2020 Jul 31;9:857. doi: 10.12688/f1000research.25277.1. eCollection 2020.

DOI:10.12688/f1000research.25277.1

PMID:34621521

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8482050/

Abstract

This study aimed to identify and examine systematic review evidence of health and social care interventions for the community-dwelling older population regarding unplanned hospital admissions, timely hospital discharge and patient well-being. A meta-review was conducted using Joanna Briggs and PRISMA guidance. A search strategy was developed: eight bibliographic medical and social science databases were searched, and references of included studies checked. Searches were restricted to OECD countries and to systematic reviews published between January 2013-March 2018. Data extraction and quality appraisal was undertaken by one reviewer with a random sample screened independently by two others. Searches retrieved 21,233 records; using data mining techniques, we identified 8,720 reviews. Following title and abstract and full-paper screening, 71 systematic reviews were included: 62 quantitative, seven qualitative and two mixed methods reviews. There were 52 reviews concerned with healthcare interventions and 19 reviews concerned with social care interventions. This meta-review summarises the evidence and evidence gaps of nine broad types of health and social care interventions. It scrutinises the presence of research in combined health and social care provision, finding it lacking in both definition and detail given. This meta-review debates the overlap of some of the person-centred support provided by community health and social care provision. Research recommendations have been generated by this process for both primary and secondary research. Finally, it proposes that research recommendations can be delivered on an ongoing basis if meta-reviews are conducted as living systematic reviews. This meta-review provides evidence of the effect of health and social care interventions for the community-dwelling older population and identification of evidence gaps. It highlights the lack of evidence for combined health and social care interventions and for the impact of social care interventions on health care outcomes. PROSPERO ID CRD42018087534; registered on 15 March 2018.

摘要

本研究旨在识别和检查针对社区居住的老年人群体的健康和社会保健干预措施的系统评价证据，这些干预措施涉及非计划性住院、及时出院和患者福祉。采用 Joanna Briggs 和 PRISMA 指南进行了元评价。制定了搜索策略：在八个医学和社会科学文献数据库中进行了搜索，并检查了纳入研究的参考文献。搜索仅限于经合组织国家和 2013 年 1 月至 2018 年 3 月期间发表的系统评价。由一名评审员进行数据提取和质量评估，另外两名评审员对随机样本进行了独立筛查。搜索共检索到 21233 条记录；通过数据挖掘技术，我们确定了 8720 条评论。经过标题和摘要以及全文筛选，共有 71 项系统评价被纳入：62 项定量研究、7 项定性研究和 2 项混合方法研究。其中 52 项研究涉及医疗保健干预措施，19 项研究涉及社会保健干预措施。这项元评价总结了九种广泛类型的健康和社会保健干预措施的证据和证据差距。它仔细审查了在综合健康和社会保健服务提供方面的研究情况，发现无论是在定义还是细节方面都存在不足。这项元评价对一些社区卫生和社会保健提供的以患者为中心的支持的重叠进行了辩论。通过这一过程提出了针对初级和二级研究的研究建议。最后，它提出如果将元评价作为实时系统评价进行，那么可以持续提供研究建议。这项元评价提供了社区居住的老年人群体的健康和社会保健干预措施的效果证据和证据差距。它突出了缺乏综合健康和社会保健干预措施以及社会保健干预措施对医疗保健结果影响的证据。PROSPERO ID CRD42018087534；于 2018 年 3 月 15 日注册。