title: Transitional care of older adults in skilled nursing facilities: A systematic review.
abstract: Transitional care may be an effective strategy for preparing older adults for transitions from skilled nursing facilities (SNF) to home. In this systematic review, studies of patients discharged from SNFs to home were reviewed. Study findings were assessed (1) to identify whether transitional care interventions, as compared to usual care, improved clinical outcomes such as mortality, readmission rates, quality of life or functional status; and (2) to describe intervention characteristics, resources needed for implementation, and methodologic challenges. Of 1082 unique studies identified in a systematic search, the full texts of six studies meeting criteria for inclusion were reviewed. Although the risk for bias was high across studies, the findings suggest that there is promising but limited evidence that transitional care improves clinical outcomes for SNF patients. Evidence in the review identifies needs for further study, such as the need for randomized studies of transitional care in SNFs, and methodological challenges to studying transitional care for SNF patients.
authors.affiliation: University of North Carolina at Chapel Hill, School of Nursing, Carrington Hall, CB#7460, Chapel Hill, NC 27599, USA. Electronic address: mtoles@email.unc.edu.
authors.forename: Mark
authors.initials: M
authors.lastname: Toles
authors.affiliation: Duke University, School of Medicine, 2100 Erwin Rd, Durham, NC 27705, USA.
authors.forename: Cathleen
authors.initials: C
authors.lastname: Colón-Emeric
authors.affiliation: University of North Carolina at Chapel Hill, School of Nursing, Carrington Hall, CB#7460, Chapel Hill, NC 27599, USA.
authors.forename: Josephine
authors.initials: J
authors.lastname: Asafu-Adjei
authors.affiliation: University of North Carolina, Health Sciences Library, 335 S. Columbia Street, CB#7585, Chapel Hill, NC 27599-7585, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Moreton
authors.affiliation: University of North Carolina, School of Medicine, 321 S Columbia St, Chapel Hill, NC 27516, USA.
authors.forename: Laura C
authors.initials: LC
authors.lastname: Hanson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006295:Health Resources; D006801:Humans; D008297:Male; D009026:Mortality; D010351:Patient Discharge; D010359:Patient Readmission; D011788:Quality of Life / Q000523:psychology; D012866:Skilled Nursing Facilities / Q000458:organization & administration*; D000069341:Transitional Care / Q000458:organization & administration*
keywords: Skilled nursing facilities; Systematic review; Transitional care