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Evidence-based risk factors for adverse health outcomes in older patients after discharge home and assessment tools: a systematic review
- Authors:
- PREYDE Michèle, BRASSARD Kristie
- Journal article citation:
- Journal of Evidence-Based Social Work, 8(5), October 2011, pp.445-468.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Many elderly patients experience adversity post-discharge from acute care settings. Hospital readmission is common; however, it is only one aspect of adverse outcomes of importance to social work discharge planners, with other health outcomes including mortality, admission to an institution, or a clinically significant decline in physical or psychosocial functioning. The early recognition of risk factors might ensure a successful transition from the hospital to the home. The purpose of this systematic review was to identify factors associated with adverse outcomes in older patients discharged from hospital to home. A second purpose was to identify and assess discharge assessment tools that could identify these risk factors. Following a comprehensive search, 43 articles that identified risk factors were selected for analysis. The risk factors were characterised in 5 domains: demographic factors; patient characteristics; medical and biological factors; social factors; and discharge factors. The most frequently reported risks were depression, poor cognition, comorbidities, length of hospital stay, prior hospital admission, functional status, patient age, multiple medications, and lack of social support. Four discharge assessment tools for use with the general population of elderly patients were identified.