Including caregivers in planning the discharge of older patients reduces hospital readmissions

Rodakowski J, Rocco PB, Ortiz M, et al.  Caregiver integration during discharge planning for older adults to reduce resource use: A metaanalysis  Journal of the American Geriatrics Society. 2017;65(8):1748-1755.

Review question

• What are the effects of including caregivers in planning the discharge of older patients from hospitals on healthcare costs and the use of healthcare resources?

Background

• Complex instructions are usually provided to informal and family caregivers when older patients are discharged from hospitals (for example, instructions on how they should take care of their wounds, giving medications and using medical equipment).
• Caregivers often express dissatisfaction with the discharge-planning process.   
• This systematic review seeks to explore the effects of integrating caregivers into the discharge-planning process.

How the review was done

• A detailed search of a number of electronic databases for studies published from 1990 up to April 2016 was conducted. Studies that focused on patient discharge planning for older adults were included in the review.
• A total of 10,715 studies were identified in the initial database search, and 15 were included in the review.
• The systematic review was funded by the Stern Family Foundation.

What the researchers found

• The review found that including caregivers in hospital-discharge planning reduces the risk of readmission at 90 days and 180 days.
• Most studies reported that including caregivers in hospital-discharge planning reduced the length of stay for individuals rehospitalized after discharge.
• Most studies reported that including caregivers in hospital-discharge planning significantly reduced the cost of care after discharge.

Conclusion

• The review found that including caregivers in hospital-discharge planning reduces the risk of readmissions, rehospitalization length of stay, and costs of care after discharge.