Evidence-based risk factors for adverse health outcomes in older patients after discharge home and assessment tools: a systematic review.
The current health care system is discharging elderly patients "quicker" and "sicker" from acute care facilities. Consequently, hospital readmission is common; however, readmission may be only one aspect of adverse outcomes of importance to social work discharge planners. The early recognition of risk factors might ensure a successful transition from the hospital to the home. A systematic review was conducted to identify factors associated with adverse outcomes in older patients discharged from hospital to home. Using a content analysis, factors were characterized in five domains: demographic factors, patient characteristics, medical and biological factors, social factors, and discharge factors. The most frequently reported risks were depression, poor cognition, comorbidities, length of hospital stay, prior hospital admission, functional status, patient age, multiple medications, and lack of social support. A systematic search identified four discharge assessment tools for use with the general population of elderly patients. Practice and research implications are offered.
Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada. mpreyde@uoguelph.ca
Michèle
M
Preyde
Kristie
K
Brassard
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D015577:Geriatric Assessment / Q000379:methods* / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008603:Mental Health; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data; D019338:Polypharmacy; D012307:Risk Factors; D012944:Social Support; D012947:Social Work; D012959:Socioeconomic Factors