Volume 27, Issue 5 pp. 1076-1086

The effects of aftercare on chronic patients and frail elderly patients when discharged from hospital: a systematic review

Gerrie J.J.W. Bours MNS RN

Gerrie J.J.W. Bours MNS RN

Department of Nursing Science, Universiteit Maastricht,

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Corry A.J. Ketelaars PhD RN

Corry A.J. Ketelaars PhD RN

I.G.Z., Limburg,

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Carla M.A. Frederiks PhD RN

Carla M.A. Frederiks PhD RN

Department of General Practice and Social Medicine, Katholieke Universiteit, Nijmegen,

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Huda Huyer Abu-Saad PhD RN

Huda Huyer Abu-Saad PhD RN

Department of Nursing Science, Universiteit Maastricht,

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Emiel F.M. Wouters PhD MD

Emiel F.M. Wouters PhD MD

Department of Pulmonology, Universiteit Maastrich, Maastricht, The Netherlands

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First published: 18 November 2003
Citations: 21
Ms G.J.J.W. Bours, Department of Nursing Science, Universiteit Maastricht, PO Box 616, 6200 MD Maastricht, The Netherlands.

Abstract

The purpose of this systematic review was an assessment of the efficacy of aftercare in chronic patients and the frail elderly when discharged from hospital, as regards quality of life, compliance, costs, medical consumption and quality of care. In pursuit of this goal, 17 publications on the effects of aftercare after discharge from hospital were examined. A systematic assessment of methodological quality by two blinded independent reviewers resulted in a consensus score (0–100 points), based on four categories: the study population, description of the interventions, measurement of the outcome and the analysis and presentation of the data. Only three of the 17 studies scored more than 50 points, indicating that most of the studies were of poor methodological quality. The most prevalent methodological problems were that co-interventions were not avoided, a placebo group was lacking, the assessment was not blinded and the analysis was not made on the basis of the intention-to-treat principle. The majority of the studies did not report clear beneficial effects in favour of the intervention group. The positive effects reported were limited to costs and quality of care.

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