Facilitating Equitable Subacute-to-Home Transitions for Patients Receiving Palliative and/or End-of-Life Care: A Literature Review
Bibliographic record
Abstract
Introduction: As people in subacute facilities approach the end of life, the focus of their care often shifts to comfort as they seek to return home. Interventions that aim to improve hospital-to-home transitions do not generally focus on subacute care. Objective: To summarize the existing literature on subacute-to-home transitions for individuals receiving palliative care near the end of life, and to explore whether these interventions are targeted toward marginalized groups to improve their transition experience. Methods: We searched the MEDLINE, Embase, HealthSTAR, and Cochrane Library electronic databases using terms related to end of life, palliative care, and transitions from subacute facilities to home. We identified 896 records and included 29 articles, 11 of which were intervention articles. We searched the 11 intervention articles for equity stratifiers. Results: Of the 29 included articles, four addressed transitions for end-of-life populations, three discussed family caregiver perspectives, and 11 were intervention studies, including regular home visit follow-ups, individualized transition care plans, and an individualized intervention with an advanced practice nurse. Subacute-to-home interventions showed positive outcomes such as reduced risk of hospital readmissions, reduced length of stays, and improved functional status. However, study limitations included small sample sizes, inconsistent definitions of outcomes, and incompletion due to COVID-19. No studies focused on marginalized groups. Conclusion/Discussion: While there was some literature supporting targeted interventions for subacute-to-home transitions for those receiving palliative care or end-of-life care, the included interventions did not target marginalized groups. Further research in these areas is required.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.030 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.004 |
| Bibliometrics | 0.018 | 0.017 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
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; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
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".