Department of Public Health, Aarhus University, Aarhus, Denmark.
Department of Research, Horsens Regional Hospital, Horsens, Denmark.
Front Public Health. 2022 Jul 11;10:898359. doi: 10.3389/fpubh.2022.898359. eCollection 2022.
The demand for healthcare is increasing due to an aging population, more people living with chronic diseases and medical comorbidities. To manage this demand, political institutions call for action to reduce the potentially avoidable hospitalizations. Quantitative and qualitative aspects should be considered to understand how and why interventions work, and for whom. The aim of this mixed methods systematic review was to identify and synthesize evidence on interventions targeting avoidable hospitalizations from the perspectives of the citizens and the healthcare professionals to improve the preventive healthcare services.
A mixed methods systematic review was conducted following the JBI methodology using a convergent integrated approach to synthesis. The review protocol was registered in PROSPERO, reg. no. CRD42020134652. A systematic search was undertaken in six databases. In total, 45 articles matched the eligibility criteria, and 25 of these (five qualitative studies and 20 quantitative studies) were found to be of acceptable methodological quality. From the 25 articles, 99 meaning units were extracted. The combined evidence revealed four categories, which were synthesized into two integrated findings: (1) Addressing individual needs through care continuity and coordination prevent avoidable hospitalizations and (2) Recognizing preventive care as an integrated part of the healthcare work to prevent avoidable hospitalizations.
The syntheses highlight the importance of addressing individual needs through continuous and coordinated care practices to prevent avoidable hospitalizations. Engaging healthcare professionals in preventive care work and considering implications for patient safety may be given higher priority. Healthcare administers and policy-makers could support the delivery of preventive care through targeted educational material aimed at healthcare professionals and simple web-based IT platforms for information-sharing across healthcare settings. The findings are an important resource in the development and implementation of interventions to prevent avoidable hospitalizations, and may serve to improve patient safety and quality in preventive healthcare services. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=134652, identifier: CRD42020134652.
由于人口老龄化、更多人患有慢性疾病和合并症，医疗保健需求不断增加。为了满足这种需求，政治机构呼吁采取行动减少潜在可避免的住院治疗。为了了解干预措施为何以及为何对某些人有效，应考虑定量和定性方面。本混合方法系统综述的目的是从公民和医疗保健专业人员的角度确定和综合针对可避免住院治疗的干预措施的证据，以改善预防保健服务。
采用 JBI 方法学，使用收敛综合方法进行了混合方法系统综述。该综述方案已在 PROSPERO 中注册，注册号为 CRD42020134652。在六个数据库中进行了系统搜索。共有 45 篇文章符合入选标准，其中 25 篇（5 篇定性研究和 20 篇定量研究）被认为具有可接受的方法学质量。从这 25 篇文章中提取了 99 个意义单位。综合证据揭示了四个类别，将其综合为两个综合发现：（1）通过护理连续性和协调性满足个体需求可预防可避免的住院治疗，（2）将预防保健视为医疗保健工作的一个综合组成部分，以预防可避免的住院治疗。
综合结果强调了通过持续和协调的护理实践满足个体需求以预防可避免住院治疗的重要性。让医疗保健专业人员参与预防保健工作并考虑对患者安全的影响可能会被赋予更高的优先级。医疗保健管理人员和政策制定者可以通过针对医疗保健专业人员的有针对性的教育材料和跨医疗保健环境的信息共享的简单基于网络的 IT 平台来支持预防保健服务的提供。这些发现是制定和实施预防可避免住院治疗干预措施的重要资源，可能有助于提高预防保健服务的患者安全性和质量。
