用户名: 密码: 验证码:
Efectividad de las intervenciones de revisi贸n de la utilizaci贸n inadecuada de la hospitalizaci贸n. Una revisi贸n sistem谩tica
详细信息查看全文 | 推荐本文 |
摘要

Objective

To evaluate the effectiveness of interventions aimed at reducing inappropriate hospital use, identified with diagnosis-independent and explicit criteria methods.

Material and methods

Systematic review of the literature to identify evaluative studies of interventions for reducing inappropriate hosp矛tal use, followed by a narrative synthesis of their characteristics and results. Works were included in English, French or Spanish languages, with experimental, quasi-experimental or observational designs, and with or without group control.

Results

We found 15 evaluative studies (2 randomised clinical trials, 8 quasi-experimental with control group and 5 with beforeafter without control group designs), the majority of them carried out in the United States (3 in Spain). The heterogeneity in hospital characteristics, hospitalisation units, patients characteristics, sampling unit, instruments, and presentation of results limited the quantitative synthesis. Feedback and administrative interventions were the most common. All the studies except 2 were positive, showing reductions in several outcomes (percentage of inappropriate stays, inappropriate admissions or inappropriate stays in the day previous to discharge, and in the length of stay). Intensive interventions that combined educational, feedback, self-assesment and administrative components showed the best results.

Conclusions

The literature review suggests that several interventions are effective to reduce inappropriate hospital use, particularly if they are direct, active, reach the doctors and combine several components.

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700