Abstract：
OBJECTIVE: Hospital admissions can be hazardous for older adults, particularly those living in long-term care facilities. Preventing nonessential admissions can be beneficial for this population, as well as reducing demand on health services. This review summarizes the economic evidence surrounding effective interventions to reduce hospital attendances and admissions for people living in long-term care facilities.
METHODS: Rapid review of economic evidence.
METHODS: People living in long-term facilities.
METHODS: We searched MEDLINE, CINAHL, Cochrane CENTRAL, PubMed, and Web of Science on September 20, 2022, and again on January 10, 2023. Full economic evaluations and cost analyses reporting on advanced care planning, goals of care setting, nurse practitioner input, palliative care, influenza vaccinations, and enhancing access to intravenous therapies were eligible. Data were extracted using a prepiloted data extraction form and critically appraised using either the Drummond-Jefferson checklist or an amended NIH Critical Appraisal Tool appended with questions from a critical appraisal checklist for cost analyses. Data were synthesized narratively.
RESULTS: We included 7 studies: 3 full economic evaluations and 4 cost analyses. Because of lack of clarity on the underlying study design, we did not include one of the cost analyses in our synthesis. Advanced care planning, a palliative care program, and a high-dose influenza vaccination reported potential cost savings. Economic evidence for a multicomponent intervention and a nurse practitioner model was inconclusive. The overall quality of the evidence varied between studies.
CONCLUSIONS: A number of potentially cost-effective approaches to reduce demand on hospital services from long-term care facilities were identified. However, further economic evaluations are needed to overcome limitations of the current evidence base and offer more confident conclusions.
METHODS: Rapid review of economic evidence.
METHODS: People living in long-term facilities.
METHODS: We searched MEDLINE, CINAHL, Cochrane CENTRAL, PubMed, and Web of Science on September 20, 2022, and again on January 10, 2023. Full economic evaluations and cost analyses reporting on advanced care planning, goals of care setting, nurse practitioner input, palliative care, influenza vaccinations, and enhancing access to intravenous therapies were eligible. Data were extracted using a prepiloted data extraction form and critically appraised using either the Drummond-Jefferson checklist or an amended NIH Critical Appraisal Tool appended with questions from a critical appraisal checklist for cost analyses. Data were synthesized narratively.
RESULTS: We included 7 studies: 3 full economic evaluations and 4 cost analyses. Because of lack of clarity on the underlying study design, we did not include one of the cost analyses in our synthesis. Advanced care planning, a palliative care program, and a high-dose influenza vaccination reported potential cost savings. Economic evidence for a multicomponent intervention and a nurse practitioner model was inconclusive. The overall quality of the evidence varied between studies.
CONCLUSIONS: A number of potentially cost-effective approaches to reduce demand on hospital services from long-term care facilities were identified. However, further economic evaluations are needed to overcome limitations of the current evidence base and offer more confident conclusions.
摘要：
目标：入院对老年人来说可能是危险的，特别是那些生活在长期护理设施中的人。预防不必要的入院对这个人群是有益的，以及减少对卫生服务的需求。这篇综述总结了围绕有效干预措施的经济证据，以减少居住在长期护理设施中的人们的住院人数和入院人数。
方法：经济证据快速回顾。
方法：人们生活在长期设施中。
方法：我们搜索了MEDLINE，CINAHL,科克伦中部,PubMed,和WebofScience于2022年9月20日发布，并于2023年1月10日再次发布。全面的经济评估和成本分析报告高级护理计划，护理设定的目标，护士从业者输入，姑息治疗,流感疫苗接种,和增加获得静脉治疗是合格的。使用预先编制的数据提取表提取数据，并使用Drummond-Jefferson清单或修订的NIH关键评估工具进行严格评估，并附有关键评估清单中的问题，以进行成本分析。数据是叙述式合成的。
结果：我们包括7项研究：3项全面经济评估和4项成本分析。由于底层研究设计缺乏清晰度，我们没有在我们的综合中包括其中一项成本分析。高级护理计划，姑息治疗方案,大剂量流感疫苗接种报告了潜在的成本节约。多组分干预和执业护士模型的经济证据尚无定论。证据的总体质量在研究之间有所不同。
结论：确定了一些可能具有成本效益的方法来减少长期护理机构对医院服务的需求。然而,需要进一步的经济评估来克服当前证据基础的局限性，并提供更有信心的结论。
方法：经济证据快速回顾。
方法：人们生活在长期设施中。
方法：我们搜索了MEDLINE，CINAHL,科克伦中部,PubMed,和WebofScience于2022年9月20日发布，并于2023年1月10日再次发布。全面的经济评估和成本分析报告高级护理计划，护理设定的目标，护士从业者输入，姑息治疗,流感疫苗接种,和增加获得静脉治疗是合格的。使用预先编制的数据提取表提取数据，并使用Drummond-Jefferson清单或修订的NIH关键评估工具进行严格评估，并附有关键评估清单中的问题，以进行成本分析。数据是叙述式合成的。
结果：我们包括7项研究：3项全面经济评估和4项成本分析。由于底层研究设计缺乏清晰度，我们没有在我们的综合中包括其中一项成本分析。高级护理计划，姑息治疗方案,大剂量流感疫苗接种报告了潜在的成本节约。多组分干预和执业护士模型的经济证据尚无定论。证据的总体质量在研究之间有所不同。
结论：确定了一些可能具有成本效益的方法来减少长期护理机构对医院服务的需求。然而,需要进一步的经济评估来克服当前证据基础的局限性，并提供更有信心的结论。
