Transitional Care Interventions Connected to Improved Outcomes Among Residents in LTC

Based on emerging evidence, study authors observed that lower readmission rates are connected to transitional care interventions for residents in long-term care (LTC) facilities aged 65 years and older.

In order to determine the correlation, study authors searched MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature for controlled design studies evaluating transitional care interventions. Of 14,538 records, 15 quantitative studies and 4 qualitative studies met eligibility criteria.

Primary outcome measures included 30-, 60-, and 90-day readmission rates to the hospital or emergency department (ED). Other measures included length of stay (LOS), functional indepence (based on the Barthel score), and quality of life.

“People allocated to transitional care interventions were 1.7 times less likely to be readmitted to the hospital or ED compared with those in control groups (14 studies; odds ratio, 1.66 [95% CI, 1.18-2.35]; I² = 81% [95% CI, 70%-88%]),” stated study authors.

For intervention groups, LOS in the ED substantially decreased (3 studies; standardized mean difference, -3.00 [95% CI, -3.61 to -2.39]; I² = 99% [95% CI, 98%-99%]).

Researchers reported no significant differences for other outcomes and factors associated with outcomes were referral processes and communication between health care professionals.

A major challenge for health care systems is improving the quality of care for older people in LTC facilities who transition from one care setting or level to another. This data supports the hypothesis that interventions have the potential to prevent readmission; however, authors said, “Despite this and with aging populations, investment in such interventions has been remarkably low across most countries.”

“While developing and implementing such interventions, careful consideration is recommended on the quality of communication and role expectations of staff members across settings, and the availability of infrastructure and technology to enable information flow,” concluded researchers. “Finally, it is important for transitional care interventions to demonstrate their effectiveness in improving an agreed set of important outcomes for patients, staff members, and the health and care systems.”

Reference:
Birtwell K, Planner C, Hodkinson A, et al. Transitional care interventions for older residents of long-term care facilities a systematic review and meta-analysis. JAMA Netw Open. 2022;5(5):e2210192. doi:10.1001/jamanetworkopen.2022.10192