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. 2021 Jan 8;11(1):e040057. doi: 10.1136/bmjopen-2020-040057

Table 1.

Study characteristic

Author (year) Country
setting		 Design Intervention Study population Mean age, years (SD) or median (range) Female n (%) Outcomes OA Readmission (event/total) RR (CI)
Buurman et al24 (2016) Netherland RCT Transitional care bridge programme intervention T: 674 I: 79.7 (7.3) I: 195 (57.9)

  • Readmission

 182 I: 106/316 1.15 (0.91–1.45)
Multicentre study I: 337 C: 80.0 (7.8) C: 195 (57.9)

  • Katz Index of ADL

 C: 88/303
  C:337    

  • Mortality

  
  Unselected patients    

  • Cognitive functioning

  
       

  • Time to hospital readmission

  
       

  • Time to discharge from a nursing home

  
Chow and Wong22 (2014) Hong Kong NRCT The nurse case management intervention T: 312 Ia: 75.00 (60–92) Ia: 46 (52.9)

  • Readmission

 28 Ia:14/91 Ia: 0.67
Single-centre study Ia: 96 Ib: 75.50 (60–89) Ib: 52 (54.2)

  • Quality of life

 Ib: 16/100 (0.37–1.22)
  Ib: 108 C: 77.00 (60–89) C: 49 (50.0)

  • Self-efficacy

 C: 24/105 Ib: 0.70
  C: 108    

  • Self-rated health

   (0.40–1.24)
  Unselected patients       84 Ia: 32/97 Ia: 0.73
          Ib: 30/106 (0.52–1.03)
          C: 59/130 Ib: 0.62
            (0.43–0.89)
Courtney et al25 (2009) Australia RCT Older hospitalised patients’ discharge planning and in-home follow-up protocol T: 128 I: 78.1 (6.3) I: 36 (62.1)

  • Readmission

 28 I: 2/49 0.26
Single-centre study I: 64 C: 79.4 (7.3) C: 40 (62.5)

  • Visits to emergency department

 C: 9/58 (0.06–1.15)
  C: 64    

  • Visits to general practitioner

  
  Patients at risk    

  • Visits to allied health professional

 84 I: 10/49 0.74 (0.37–1.48)
       

  • Health-related quality of life

 C: 16/58
          168 I: 11/49 0.48 (0.27–0.87)
          C: 27/58
Finlayson et al23 (2018) Australia RCT NR T: 222 Ic: 77.1 (7.64) Ic: 46 (80.7)

  • Readmission

 28 Ic: 4/53 Ic: 0.31
Multicentre study Ic: 57 Id: 77.6 (6.50) Id: 42 (75.0) Id: 7/49 (0.11–0.89)
  Id:56 Ie: 77.8 (6.23) Ie: 37 (68.5) Ie: 5/49 Id: 0.58
  Ie:54 C: 77.9 (6.20) C: 37 (67.3) C: 13/53 (0.25–1.33)
  C:55       Ie: 0.42
  Patients at risk       (0.16–1.09)
        84 Ic: 11/53 Ic: 0.55
        Id: 16/44 (0.29–1.04)
        Ie: 9/48 Id: 0.96
        C: 19/50 (0.57–1.63)
          Ie: 0.49
          (0.25–0.97)
        168 Ic: 18/52 Ic: 0.75
        Id: 18/42 (0.46–1.21)
        Ie: 16/47 Id: 0.93
        C: 23/50 (0.59–1.47)
          Ie: 0.74
          (0.45–1.22)
Koehler et al26 (2009) USA RCT (pilot) Elderly care bundle T: 41 I: 77.2 (5.3) I: 17 (85)

  • Readmission

 30 I: 2/20 0.26 (0.06–1.08)
Single-centre study I: 20 C: 79.8 (5.6) C: 13 (62)

  • Emergency department visits

 C: 8/21
  C:21        
  Patients at risk       60 I: 6/20 0.70 (0.30–1.61)
          C: 9/21
Lin et al31 (2015) Hong Kong Cohort analytic (two groups pre–post study) Integrated care and discharge support for elderly patients T: NR Total: 80.4±7.6 T: 557 (51.1)

  • Readmission

 182 pre NR NR
Multicentre study I: 1090 I: NR

  • AED attendance

 182 post Reports a statistically significant reduction on 47% in readmissions
  C: NR C: NR

  • LOS

  
  Patients at risk      
Nielsen et al28 (2018) Denmark NRCT Elderly activity performance intervention T: 375 I: 81 (7.9) I: 79 (55)

  • Readmission

 30 I: 25/139 0.76 (0.50–1.16)
Single-centre study I:144 C: 78 (8.6) C: 122 (53)

  • All-cause mortality

 C: 55/231
  C: 231    

  • Number of contacts to general practitioners and emergency departments without admission

  
  Unselected patients    

  • Time to first readmission

 182 I: 64/144 1.04 (0.82–1.32)
          C: 99/231
Robinson et al32 (2015) New Zealand Cohort analytic (two groups pre–post study) Integrated transition of care T: 19 157 I: 78.2 (9.2) I: 2486 (48.1)

  • Readmission

 7 I: 500/5172 1.09 (0.99–1.20)
Multicentre study I: 5172 C: 77.6 (9.1) C: 6765 (48.4)

  • Emergency attendances

 C: 1239/13 985
  C:13 985       28 I: 1370/5172 1.03 (0.98–1.09)
  Patients at risk       C: 3588/13 985
          90 I: 2281/5172 1.01 (0.97–1.05)
          C: 6079/13 985
Rottman-Sagebiel et al29 (2018) USA NRCT The geriatrics medication education at discharge project T: 1624 I: 74.9 (7.6) I: 14 (3.6)

  • Readmission

 30 NR NR
  I: 435 C: 75.2 (8.35) C: 26 (2.2)
Single-centre study C: 1189    
       
  Patients at risk    
Sahota et al27 (2017) UK RCT The community in-reach rehabilitation and care transition T: 250 I: 83.6 (6.6) I: 82 (66)

  • Readmission

 28 I: 18/106 1.29 (0.68–2.46)
Single-centre study I: 125 C: 84.5 (5.9) C: 79 (63)

  • LOS

 C: 14/106
    C: 125    

  • Day 91-super spell bed days

  
    Unselected patients    

  • Functional ability

  
         

  • Comorbidity

  
         

  • Health-related quality of life

  
         

  • Cost-effectiveness analysis

 91 I: 45/106 1.15 (0.82–1.61)
            C: 39/106
Voss et al30 (2011) USA NRCT Care transitions intervention T: 1888 I: NR I: NR

  • Readmission

 30 NR NR
Multicentre study I: 1042 C: NR C: NR
  C: 846    
  Unselected patients    

ADL, activity of daily living; AED, accident and emergency departments; C, control; CGA, comprehensive geriatric assessment; I, intervention; Ia, ‘Home visit’; Ib, ‘Call’; Ic, EN-HaT (exercise and nurse home visit and telephone follow-up); Id, exercise; Ie, N-HaT (nurse home visit and telephone follow-up); LOS, length of hospital stay; NR, not reported or author could not access the raw data; NRCT, non-randomised controlled trial; OA, readmission outcome assessment in days after hospital discharge; RCT, randomised trial; RR, relative risk; T, total.