Skip to main content

Table 3 Findings of included studies

From: The role of hospitals in bridging the care continuum: a systematic review of coordination of care and follow-up for adults with chronic conditions

Reference Country Clinical field Design Outcome
Transitional care interventions
 Abad-Corpa et al. 2013 [18] Spain Chronic obstructive pulmonary disease (COPD) Quasiexperimental design Variables related to readmission, level of knowledge about the therapeutic regime, quality of life, satisfaction with nursing care
 Baldwin, Black & Hammond, 2014 [19] US Chronic diseases Case study 30-day readmission
 Blue et al. 2001 [30] UK Chronic heart failure (CHF) Randomized controlled trial Death from all causes or hospital admission for heart failure at one year, death or hospital admission for any reason, hospital admission for worsening chronic heart failure, all-cause admission to hospital, number of patients admitted, number of admissions, days spent in hospital
 Brand et al. 2004 [32] Australia General medical patient aged ≥ 65 years with either a history of readmissions to acute care or multiple medical comorbidities Quasiexperimental design Unplanned acute care readmissions (representation and hospitalization for 24 h) and emergency department presentations (discharge < 24 h after presentation) at 3 and 6 months after discharge from the index admission
 Cline et al. 1998 [31] Sweden Heart failure (HF) Randomized controlled trial Hospitalization data in survivors at one year, treatment at one year follow-up
 Coleman et al. 2004 [28] US Community-dwelling adults 65 years or older with stroke, congestive heart failure, coronary artery disease, cardiac arrhythmias, chronic obstructive pulmonary disease, diabetes mellitus, stroke, medical or surgical back conditions, hip fracture, peripheral vascular disease, or cardiac arrhythmias Randomized controlled trial Complicated post hospital episode; rehospitalization within 30, 90, 180 days; Emergency room (ER) or observation unit visit within 30, 90, 180 days; time to first rehospitalization, time to first ER or observation unit visit
 Coleman et al. 2006 [29] US Community-dwelling adults 65 years or older with stroke, congestive heart failure, coronary artery disease, cardiac arrhythmias, chronic obstructive pulmonary disease, diabetes mellitus, spinal stenosis, hip fracture, peripheral vascular disease, deep venous thrombosis or pulmonary embolism Randomized controlled trial Rate of nonelective rehospitalization at 30, 60, 90 and 180 days after discharge; rehospitalization for same diagnosis as index hospitalization at 30, 60, 90 and 180 days after discharge
 Farrero et al. 2001 [24] Spain COPD Randomized controlled trial Emergency, admissions, hospital stay
 Harrison et al. 2002 [23] Canada HF Randomized controlled trial Health-related quality of life (MLHFQ, SF-36), rates of readmission, emergency room use
 Jeangsawang et al. 2012 [27] Thailand Patients with complicated healthcare needs or a high risk of poor postdischarge outcomes Mixed-method design Postdischarge functional ability, health-related complications, emergency room visits, hospital readmissions, time between hospital discharge and first readmission and length of rehospitalization stays, family member satisfaction
 Ledwidge et al. 2005 [22] Ireland HF Randomized controlled trial Mortality rates, HF-related admission rate
 Linden & Butterworth, 2014 [20] US HF and COPD Randomized controlled trial 30 and 90 day readmission incidence rates, ER visits incidence rates, mortality rates
 Naylor et al. 2004 [26] US HF Randomized controlled trial Time to first rehospitalization or death, number of rehospitalization, quality of life, functional status, costs, and satisfaction with care
 Rauh et al. 1999 [21] US CHF Retrospective analysis Length of stay, admission and readmission rates, costs to the patient and provider
 Williams et al. 2010 [25] UK CHF Quasiexperimental design Readmission, length of stay, patient satisfaction
Specialized care setting
 Akosah et al. 2002 [34] US CHF Chart review Hospital readmissions at 30 and 90 days and 1 year; risk reduction; time to hospital readmission, additional hospital admissions; mortality at 90 days and 1 year; event free survival
 Atienza et al. 2004 [35] Spain High-risk of HF Randomized controlled trial Rate of events per observation year, rate of readmitted patients per observation year, for CHF, not for CHF, rate of readmissions per observation year, for CHF, not for CHF, rate of deaths per observation year
 de la Porte et al. 2007 [36] The Netherlands HF Randomized controlled trial Hospitalization for CHF or death, death (all causes), days in hospital
 Hanumanthu et al. 1997 [37] US HF Retrospective analysis Hospitalization rate, exercise capacity
Hospital versus nonhospital care
 Chiu et al. 2001 [38] Taiwan Stroke patients with severe physical disabilities Case-control study Changes in Activities of Daily Living scores (ADL) scores, family costs for caregiving
 Grunfeld et al. 1999 [43] UK Breast cancer Randomized controlled trial Patient satisfaction
 Luttik et al. 2014 [41] The Netherlands CHF Case-control study Guideline adherence, patient adherence, number of deaths, hospital readmission, unplanned hospital readmissions
 Moalosi et al. 2003 [39] Africa Chronically ill tuberculosis patients Case-control study Outcome (died during treatment, completed treatment, defaulted, transferred out), average cost per patient treated
 Ricauda et al. 2008 [40] Italy COPD Randomized controlled trial Mortality, readmission to hospital, length of stay, depression, quality of life, cost per patient per day
 Sadatsafavi et al. 2013 [42] Canada Asthma Chart review Direct asthma-related medical cost, rate of readmission, asthma related outpatient service use, rate of short-acting β-agonist dispensation, days covered with a controller medication
 Shi et al. 2015 [33] China Hypertension or diabetes Case-control study Quality and value of care, access, continuity, coordination, comprehensiveness, satisfaction, cost concerns, and health improvement
 Vliet Vlieland et al. 1997 [44] The Netherlands Rheumatoid arthritis Randomized controlled trial Swollen and tender joint counts, patients’ assessment of pain, patients’ and the physicians’ assessments of disease activity, ESR, HAQ
Experiences and expectations of patients
 Cowie et al. 2009 [46] UK Arthritis, coronary heart disease, stroke, hypercholesterolemia, hypertension, diabetes mellitus, or chronic obstructive pulmonary disease Qualitative interview study Longitudinal and relational continuity, management continuity between organizations, access and flexibility
 Dossa et al. 2012 [55] US 70 years or older, two or more chronic conditions or mobility impairments Qualitative longitudinal interview study Communication
 Ireson et al. 2009 [48] US CHF, diabetes, COPD, colon cancer, or breast cancer Qualitative interview study Preparation for specialist visit, patient’s experience during the specialist visit, trust of physician
 Naithani et al. 2006 [45] UK Diabetes Qualitative interview study Experienced longitudinal continuity, experienced flexible continuity, experienced team and crossboundary continuity
 Williams 2004 [47] Australia Multiple chronic conditions Qualitative phenomenological study Perceptions of quality of care of acute care services