Mohamedsharif Asma, Elfeaki Mohammed, Bushra Rayan, Gemperli Armin
Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
Directorate of Quality, Development and Accreditation, Federal Ministry of Health, Khartoum, Sudan.
Front Health Serv. 2023 Dec 14;3:1288575. doi: 10.3389/frhs.2023.1288575. eCollection 2023.
Hospital discharge is often associated with a lack of continuity resulting in fragmented care, particularly in low-income countries. As there is limited information about interventions in these countries and no study evaluating the effectiveness of hospital discharge interventions, we conducted a scoping review to identify effective hospital-to-home transitional care interventions and explore their applicability in a low-income country (Sudan).
Our scoping review of systematic reviews and meta-analyses classed interventions as effective, ineffective, undesirable, or uncertain, based on the quality of their evidence and their estimated effects on the following outcomes: readmission rates, mortality, costs, quality of life, and adverse outcomes) and certainty of evidence. Our authors from Sudan used the SUPPORT summary tool to determine if three effective interventions could be implemented in Sudan.
Out of 3,276 articles that were identified, and 72 articles were reviewed, 10 articles has been included in the review. Seven interventions were classified as effective, one as ineffective, and none with undesirable effects. Eight interventions were classified as having an uncertain effect. The effective interventions were composed of home visits, information and communication technology (ICT), case manager models, multidisciplinary teams, and self-management support.
The finding of this study suggested that a combining two to four interventions can improve enhance hospital-to-home transitional care. Effective interventions are composed of home visits, ICT, case manager models, multidisciplinary teams, and self-management support. The implementation of these interventions in Sudan was found to be undermined by contextual factors such as inadequate human resources, telecommunication instability, and inequality in accessibility. These interventions could be tailored based on an in-depth understanding of the contextual factors in low-income countries that influence implementation.
https://osf.io/9eqvr/, doi: 10.17605/OSF.IO/9EQVR.
医院出院常常伴随着缺乏连续性，导致医疗服务碎片化，在低收入国家尤其如此。由于这些国家关于干预措施的信息有限，且没有研究评估医院出院干预措施的有效性，我们进行了一项范围综述，以确定有效的医院到家过渡性护理干预措施，并探讨其在低收入国家（苏丹）的适用性。
我们对系统评价和荟萃分析进行范围综述，根据证据质量及其对以下结局的估计影响（再入院率、死亡率、成本、生活质量和不良结局）以及证据的确定性，将干预措施分类为有效、无效、不良或不确定。我们来自苏丹的作者使用SUPPORT总结工具来确定三种有效干预措施是否可以在苏丹实施。
在识别出的3276篇文章中，有72篇文章被审查，10篇文章被纳入综述。七种干预措施被归类为有效，一种为无效，没有不良影响的。八种干预措施被归类为效果不确定。有效的干预措施包括家访、信息通信技术（ICT）干预、个案管理模式、多学科团队和自我管理支持。
本研究结果表明，结合两到四种干预措施可以改善医院到家的过渡性护理。有效的干预措施包括家访、ICT、个案管理模式、多学科团队和自我管理支持。发现这些干预措施在苏丹的实施受到人力资源不足、电信不稳定和可及性不平等的背景因素的影响。这些干预措施可以根据对影响低收入国家实施的背景因素的深入理解进行调整。
