Transitional care interventions from acute care to long-term care facilities: a systematic review
Bibliographic record
Abstract
Objectives: Older adults living in long-term care facilities (LTCFs) are particularly at risk during transitions in care, most notably from acute care back to their LCTF. Issues surrounding miscommunication of information or medications are often mentioned as important challenges. Transitional care interventions (TCi) have emerged as solutions to improve outcomes. The objective of this review was therefore to determine the effects of TCi on several indicators of quality of care, clinical outcomes, healthcare services use and satisfaction among older patients discharged from acute care to LTCFs. Methods: Medline, CINAHL, EMBASE, Cochrane Central and Social Work Abstracts were searched. Study selection (title/abstract, full-text), data extraction and assessment of study quality were conducted by two independent reviewers. A narrative synthesis of the data was performed. Results: From the 5,506 references identified, 11 were included. Eight studies reported on quality of care: six on medication problems, and two on advance directives. Four studies reported on clinical outcomes: three on mortality, two on mobility/function and one on confusion/behavioral symptoms. Seven studies reported on healthcare services use: six on hospital readmissions/ED visits, and five on hospital days. Three studies reported on satisfaction with TCi. While satisfaction levels were high with TCi, other outcomes were inconclusive. Medications problems appeared to be the outcome most likely to benefit from TCi. Discussion: TCi targeting the acute to long-term care transition have obtained inconclusive results so far. More studies investigating the outcomes of quality of care, clinical outcomes, healthcare services use are needed.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.003 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".