"Preventing 30-Day Hospital Readmissions: A Systematic Review and Meta-analysis of Randomized Trials" Article Analysis
In the article "Preventing 30-Day Hospital Readmissions: A Systematic Review and Meta-analysis of Randomized Trials" authors observe the evidence of the existing interventions' efficacy in order to define the best practices which may reduce early hospital readmission. In their research, the authors used evidence from Ovid MEDLINE, Ovid EMBASE, PubMed, EBSCO CINAHL and Scopus Databases, reviewed bibliographies and contacted experts. The main characteristics of the tested patients were age (65 years old and more or not), diagnosis (heart failure or other), and hospital ward. There were taken into account the intervention characteristics as well. Then a post hoc metaregression model was developed in order to test the level of patient and caregiver support provided in each particular case.
As a result of initial database, analysis was generated 1128 reports, and 256 of them were identified for full-text review. Most of the trials took place in academic medical centers, which enrolled few patients and reported 30-day readmission. The main methodological limitation of the analyzed trials was the lack of reliable methods to deal with the data which were missing. As a result of meta-analysis, it was found out that the relative risk of 30-day readmission was 0.82 (95%).
Thus, there was identified the beneficial and consistent effect of the described interventions on the risk of readmission in 30 days. The more complex interventions were the most effective. In addition, those were treated by the patients as the most reliable, so those were properly assessed as a part of postdischarge care. The research findings have proved that context-sensitive support provided to patients decreased the risk of early hospital readmission. Still, the researchers failed to identify the effect of the rated intervention workload on this risk.
References
Leppin, A. L., Gionfriddo, M. R., Kessler, M., Brito, J. P., Mair, F. S., Gallacher, K., ... & Ting, H. H. (2014). Preventing 30-day hospital readmissions: a systematic review and meta-analysis of randomized trials. JAMA internal medicine, 174(7), …
