Table 14:
Effect of Patient Care Planning Discussions on Receiving Hospital Care
| Author, Year | Study Design | Tool Used? | Results Intervention | Results Control | Effect Estimate (95% CI) |
|---|---|---|---|---|---|
|
Single-Provider Discussion vs. Usual Care or No Discussion GRADE for highest-quality evidence: High GRADE for all evidence: Moderate | |||||
| Highest-quality evidence | |||||
| Casarett et al, 2005 (48) | Large RCT | Yes | Mean number of acute care admissions (range): 0.3 (0-4) | Mean number of acute care admissions (range): 0.5 (0–4) | MD: −0.21, P = 0.04a |
| Lower-quality evidence | |||||
| Engelhardt et al, 2009 (56) | Obs-cont | Yes | Mean change in number of inpatient admissions from baseline (SD): 0.5 (6.1)b | Mean change in number of inpatient admissions from baseline (SD): 2.1 (17.3)b | MD: −1.67 (−3.82, 0.48)a,c |
| Mack et al, 2012 (58) | Obs-cont | No | Received acute care at EoL: 424/1082 (39.2%) | Received acute care at EoL: 72/149 (48.3%) | OR: 0.69 (0.49, 0.97)a |
|
Team-Based Discussion vs. Usual Care or No Discussion GRADE for all evidence: Low | |||||
| Rabow et al, 2004 (57) | Obs-cont | No | Mean (SD): 1.2 (2.0) | Mean (SD): 0.8 (1.0) | MD: 0.40 (−0.24, 1.04) |
Abbreviations: CI, confidence interval; EoL, end of life; GRADE, Grading of Recommendations Assessment, Development, and Evaluation; MD, difference in means; Obs-cont, observational study with contemporaneous controls; OR, odds ratio; RCT, randomized controlled trial; SD, standard deviation.
a
Statistically significant at P ≤ 0.05.
b
Standard deviations are slightly larger because information about the correlation between estimates was not provided.
c
Significant difference was shown in the paper, but the difference was not significant in this estimate because the SDs for the MDs were estimated conservatively.