Components of the transitional care model (TCM) to reduce readmission in geriatric patients: a systematic review
Abstract Background Demographic changes are taking place in most industrialized countries. Geriatric patients are defined by the European Union of Medical Specialists as aged over 65 years and suffering from frailty and multi-morbidity, whose complexity puts a major burden on these patients, their f...
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| Format: | Article |
| Language: | English |
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BMC
2020-09-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12877-020-01747-w |
| _version_ | 1818883696442212352 |
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| author | Nadine Morkisch Luz D. Upegui-Arango Maria I. Cardona Dirk van den Heuvel Martina Rimmele Cornel Christian Sieber Ellen Freiberger |
| author_facet | Nadine Morkisch Luz D. Upegui-Arango Maria I. Cardona Dirk van den Heuvel Martina Rimmele Cornel Christian Sieber Ellen Freiberger |
| author_sort | Nadine Morkisch |
| collection | DOAJ |
| description | Abstract Background Demographic changes are taking place in most industrialized countries. Geriatric patients are defined by the European Union of Medical Specialists as aged over 65 years and suffering from frailty and multi-morbidity, whose complexity puts a major burden on these patients, their family caregivers and the public health care system. To counteract negative outcomes and to maintain consistency in care between hospital and community dwelling, the transitional of care has emerged over the last several decades. Our objectives were to identify and summarize the components of the Transitional Care Model implemented with geriatric patients (aged over 65 years, with multi-morbidity) for the reduction of all-cause readmission. Another objective was to recognize the Transitional Care Model components’ role and impact on readmission rate reduction on the transition of care from hospital to community dwelling (not nursing homes). Methods Randomized controlled trials (sample size ≥50 participants per group; intervention period ≥30 days), with geriatric patients were included. Electronic databases (MEDLINE, CINAHL, PsycINFO and The Cochrane Central Register of Controlled Trials) were searched from January 1994 to December 2019 published in English or German. A qualitative synthesis of the findings as well as a systematic assessment of the interventions intensities was performed. Results Three articles met the inclusion criteria. One of the included trials applied all of the nine Transitional Care Model components described by Hirschman and colleagues and obtained a high-intensity level of intervention in the intensities assessment. This and another trial reported reductions in the readmission rate (p < 0.05), but the third trial did not report significant differences between the groups in the longer follow-up period (up to 12 months). Conclusions Our findings suggest that high intensity multicomponent and multidisciplinary interventions are likely to be effective reducing readmission rates in geriatric patients, without increasing cost. Components such as type of staffing, assessing and managing symptoms, educating and promoting self-management, maintaining relationships and fostering coordination seem to have an important role in reducing the readmission rate. Research is needed to perform further investigations addressing geriatric patients well above 65 years old, to further understand the importance of individual components of the TCM in this population. |
| first_indexed | 2024-12-19T15:37:45Z |
| format | Article |
| id | doaj.art-9caf08964e68424f910797bade97f768 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-19T15:37:45Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-9caf08964e68424f910797bade97f7682022-12-21T20:15:33ZengBMCBMC Geriatrics1471-23182020-09-0120111810.1186/s12877-020-01747-wComponents of the transitional care model (TCM) to reduce readmission in geriatric patients: a systematic reviewNadine Morkisch0Luz D. Upegui-Arango1Maria I. Cardona2Dirk van den Heuvel3Martina Rimmele4Cornel Christian Sieber5Ellen Freiberger6Bundesverband Geriatrie e.VBundesverband Geriatrie e.VInstitute of Biomedicine of Aging, Nuremberg, Friedrich-Alexander-University Erlangen-NurembergBundesverband Geriatrie e.VInstitute of Biomedicine of Aging, Nuremberg, Friedrich-Alexander-University Erlangen-NurembergInstitute of Biomedicine of Aging, Nuremberg, Friedrich-Alexander-University Erlangen-NurembergInstitute of Biomedicine of Aging, Nuremberg, Friedrich-Alexander-University Erlangen-NurembergAbstract Background Demographic changes are taking place in most industrialized countries. Geriatric patients are defined by the European Union of Medical Specialists as aged over 65 years and suffering from frailty and multi-morbidity, whose complexity puts a major burden on these patients, their family caregivers and the public health care system. To counteract negative outcomes and to maintain consistency in care between hospital and community dwelling, the transitional of care has emerged over the last several decades. Our objectives were to identify and summarize the components of the Transitional Care Model implemented with geriatric patients (aged over 65 years, with multi-morbidity) for the reduction of all-cause readmission. Another objective was to recognize the Transitional Care Model components’ role and impact on readmission rate reduction on the transition of care from hospital to community dwelling (not nursing homes). Methods Randomized controlled trials (sample size ≥50 participants per group; intervention period ≥30 days), with geriatric patients were included. Electronic databases (MEDLINE, CINAHL, PsycINFO and The Cochrane Central Register of Controlled Trials) were searched from January 1994 to December 2019 published in English or German. A qualitative synthesis of the findings as well as a systematic assessment of the interventions intensities was performed. Results Three articles met the inclusion criteria. One of the included trials applied all of the nine Transitional Care Model components described by Hirschman and colleagues and obtained a high-intensity level of intervention in the intensities assessment. This and another trial reported reductions in the readmission rate (p < 0.05), but the third trial did not report significant differences between the groups in the longer follow-up period (up to 12 months). Conclusions Our findings suggest that high intensity multicomponent and multidisciplinary interventions are likely to be effective reducing readmission rates in geriatric patients, without increasing cost. Components such as type of staffing, assessing and managing symptoms, educating and promoting self-management, maintaining relationships and fostering coordination seem to have an important role in reducing the readmission rate. Research is needed to perform further investigations addressing geriatric patients well above 65 years old, to further understand the importance of individual components of the TCM in this population.http://link.springer.com/article/10.1186/s12877-020-01747-wSystematic reviewTransitional careTransitional care modelGeriatric patientsReadmission |
| spellingShingle | Nadine Morkisch Luz D. Upegui-Arango Maria I. Cardona Dirk van den Heuvel Martina Rimmele Cornel Christian Sieber Ellen Freiberger Components of the transitional care model (TCM) to reduce readmission in geriatric patients: a systematic review BMC Geriatrics Systematic review Transitional care Transitional care model Geriatric patients Readmission |
| title | Components of the transitional care model (TCM) to reduce readmission in geriatric patients: a systematic review |
| title_full | Components of the transitional care model (TCM) to reduce readmission in geriatric patients: a systematic review |
| title_fullStr | Components of the transitional care model (TCM) to reduce readmission in geriatric patients: a systematic review |
| title_full_unstemmed | Components of the transitional care model (TCM) to reduce readmission in geriatric patients: a systematic review |
| title_short | Components of the transitional care model (TCM) to reduce readmission in geriatric patients: a systematic review |
| title_sort | components of the transitional care model tcm to reduce readmission in geriatric patients a systematic review |
| topic | Systematic review Transitional care Transitional care model Geriatric patients Readmission |
| url | http://link.springer.com/article/10.1186/s12877-020-01747-w |
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