Discharge Planning From Hospital to Home for Elderly Patients: A Meta-Analysis

Abstract

In the present healthcare environment, budget cuts, staff shortages, and resource limitations are grave concerns. The elderly in particular consume a considerable proportion of hospital resources. Thus, the discharge planner's role, particularly with respect to elderly patients, is extremely important. In this systematic review recent (within the last 10 years) randomized, controlled or quasi-experimental trials of discharge planning (DP) from hospital to home of patients age 65 years or older were examined. The most important finding was the paucity of investigations by social work professionals. A second important finding was the lack of appropriate reporting of methods and results. Where data were provided, an effect size was computed for statistically significant results (overall mean d = 0.51, SD 0.35). Large effects were noted for patient satisfaction, while moderate effects were evident for patients' quality of life and readmission rates. The integration and evaluation of current knowledge in this field may inform further research and may lead to the advancement of clinical practice and new policy development, with the ultimate goal of improving the quality of patient care and the quality of patient outcomes. The implications for social work clinicians and researchers are discussed.

KEYWORDS:

• Discharge planning
• elderly patients
• social work practice
• meta-analysis

Notes

‡Data not reported to compute effect size.

†Mean d-index indicating satisfaction with social work skills (.67) and social work service (1.03).

*QoL scale specific to heart failure.

**Kwok reported a trend toward higher unplanned readmission in the intervention group than control—a finding opposite to the hypothesis.

+QoL was only SS at 12 weeks (i.e., not at 6 or 52 weeks) while satisfaction was only SS at 6 weeks (i.e., not at 12 or 52 weeks).

++LOS was SS; however, it was longer for test intervention than DP as usual.

††Mean d-index of clinical functioning outcomes (e.g., recovery of walking and self-care abilities).