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A scoping review of initiatives to reduce inappropriate or non-beneficial hospital admissions and bed days in people nearing the end of their life: much innovation, but limited supporting evidence.
- Source :
- BMC Palliative Care; 2/27/2020, Vol. 19 Issue 1, p1-25, 25p
- Publication Year :
- 2020
-
Abstract
- Background: Hospitalisation during the last weeks of life when there is no medical need or desire to be there is distressing and expensive. This study sought palliative care initiatives which may avoid or shorten hospital stay at the end of life and analysed their success in terms reducing bed days. Methods: Part 1 included a search of literature in PubMed and Google Scholar between 2013 and 2018, an examination of governmental and organisational publications plus discussions with external and co-author experts regarding other sources. This initial sweep sought to identify and categorise relevant palliative care initiatives. In Part 2, we looked for publications providing data on hospital admissions and bed days for each category. Results: A total of 1252 abstracts were reviewed, resulting in ten broad classes being identified. Further screening revealed 50 relevant publications describing a range of multi-component initiatives. Studies were generally small and retrospective. Most researchers claim their service delivered benefits. In descending frequency, benefits identified were support in the community, integrated care, out-of-hours telephone advice, care home education and telemedicine. Nurses and hospices were central to many initiatives. Barriers and factors underpinning success were rarely addressed. Conclusions: A wide range of initiatives have been introduced to improve end-of-life experiences. Formal evidence supporting their effectiveness in reducing inappropriate/non-beneficial hospital bed days was generally limited or absent. Trial registration: N/A [ABSTRACT FROM AUTHOR]
- Subjects :
- EXPERIENCE
HOME care services
HOSPICE care
HOSPITAL utilization
LENGTH of stay in hospitals
HOSPITAL admission & discharge
INTEGRATED health care delivery
MEDLINE
NURSES
NURSING care facilities
ONLINE information services
PALLIATIVE treatment
PATIENTS
TELEMEDICINE
SYSTEMATIC reviews
LITERATURE reviews
Subjects
Details
- Language :
- English
- ISSN :
- 1472684X
- Volume :
- 19
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Palliative Care
- Publication Type :
- Academic Journal
- Accession number :
- 141984506
- Full Text :
- https://doi.org/10.1186/s12904-020-0526-2