Effects of Transitional Care on Hospital Readmission and Mortality Rate in Subjects With COPD: A Systematic Review and Meta-Analysis

Edi Sampurno Ridwan, Hamam Hadi, Yu Lin Wu, Pei Shan Tsai

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

BACKGROUND: Studies on the effect of transitional care on hospital readmissions have reported inconsistent findings, and the effect on mortality has not been reviewed systematically. This systematic review and meta-analysis of randomized controlled trials aims to examine the effect of transitional care interventions on COPD-related readmissions, all-cause hospital readmissions, and all-cause mortality rates in subjects with COPD. METHODS: Electronic databases (CINAHL, Embase, Scopus, MEDLINE, Cochrane, PubMed, Web of Science, Airity, BMJ Respiratory Research Journal, and National Digital Library of Theses and Dissertations) were searched from inception to April 26, 2017. Online searches were conducted using key words and MeSH terms for COPD and transitional care. Entry terms for searching included chronic obstructive pulmonary disease, COPD, COPD transitional care or care transition, continuity of patient care, patient discharge, and patient transfer. The quality of the included trials was assessed using the Cochrane Collaboration tool. RESULTS: 13 randomized controlled trials met the inclusion criteria. Transitional care significantly reduced the risk of COPD-related readmissions (odds ratio = 0.599, 95% CI 0.421-0.852) and all-cause hospital readmissions (odds ratio = 0.720, 95% CI 0.531-0.978), but not that of all-cause mortality (odds ratio = 0.863, 95% CI 0.576-1.294) in subjects with COPD. The effects of transitional care on hospital readmissions were moderated by the duration of interventions, type of care providers, and use of telephone follow-up as an element of the intervention. CONCLUSIONS: There was a significant effect of transitional care on both COPD-related and all-cause hospital readmissions in subjects with COPD. Duration of interventions, type of care providers, and use of telephone follow-up appeared to moderate the beneficial effects of transitional care.

Original languageEnglish
Pages (from-to)1146-1156
Number of pages11
JournalRespiratory Care
Volume64
Issue number9
DOIs
Publication statusPublished - Sep 1 2019

Fingerprint

Patient Readmission
Hospital Mortality
Chronic Obstructive Pulmonary Disease
Meta-Analysis
Mortality
Patient Transfer
Odds Ratio
Telephone
Randomized Controlled Trials
Transitional Care
Digital Libraries
Continuity of Patient Care
Patient Discharge
PubMed
MEDLINE
Databases

Keywords

  • continuity of patient care
  • COPD
  • patient discharge
  • patient transfer
  • transition care
  • transitional care

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Effects of Transitional Care on Hospital Readmission and Mortality Rate in Subjects With COPD : A Systematic Review and Meta-Analysis. / Ridwan, Edi Sampurno; Hadi, Hamam; Wu, Yu Lin; Tsai, Pei Shan.

In: Respiratory Care, Vol. 64, No. 9, 01.09.2019, p. 1146-1156.

Research output: Contribution to journalReview article

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abstract = "BACKGROUND: Studies on the effect of transitional care on hospital readmissions have reported inconsistent findings, and the effect on mortality has not been reviewed systematically. This systematic review and meta-analysis of randomized controlled trials aims to examine the effect of transitional care interventions on COPD-related readmissions, all-cause hospital readmissions, and all-cause mortality rates in subjects with COPD. METHODS: Electronic databases (CINAHL, Embase, Scopus, MEDLINE, Cochrane, PubMed, Web of Science, Airity, BMJ Respiratory Research Journal, and National Digital Library of Theses and Dissertations) were searched from inception to April 26, 2017. Online searches were conducted using key words and MeSH terms for COPD and transitional care. Entry terms for searching included chronic obstructive pulmonary disease, COPD, COPD transitional care or care transition, continuity of patient care, patient discharge, and patient transfer. The quality of the included trials was assessed using the Cochrane Collaboration tool. RESULTS: 13 randomized controlled trials met the inclusion criteria. Transitional care significantly reduced the risk of COPD-related readmissions (odds ratio = 0.599, 95{\%} CI 0.421-0.852) and all-cause hospital readmissions (odds ratio = 0.720, 95{\%} CI 0.531-0.978), but not that of all-cause mortality (odds ratio = 0.863, 95{\%} CI 0.576-1.294) in subjects with COPD. The effects of transitional care on hospital readmissions were moderated by the duration of interventions, type of care providers, and use of telephone follow-up as an element of the intervention. CONCLUSIONS: There was a significant effect of transitional care on both COPD-related and all-cause hospital readmissions in subjects with COPD. Duration of interventions, type of care providers, and use of telephone follow-up appeared to moderate the beneficial effects of transitional care.",
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