Systematic Review and Meta-Analysis of Unplanned Reoperations, Emergency Department Visits and Hospital Readmission After Thyroidectomy

Thyroid ◽  
2018 ◽  
Vol 28 (5) ◽  
pp. 624-638 ◽  
Author(s):  
Joseph Margolick ◽  
Wenjia Chen ◽  
Sam M. Wiseman
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Hospital Readmission ◽  
Meta Analysis ◽  
Emergency Department Visits

scholarly journals Impact of Pharmacist-led Discharge Counseling on Hospital Readmission and Emergency Department Visits: A Systematic Review and Meta-analysis

2019 ◽  
Vol 15 (01) ◽  
pp. 52-59 ◽  
Author(s):  
Aline Bonetti ◽  
Walleri C Reis ◽  
Antonio M Mendes ◽  
Inajara Rotta ◽  
Fernanda S Tonin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Usual Care ◽  
Hospital Readmission ◽  
Data Extraction ◽  
Meta Analysis ◽  
Emergency Department Visits ◽  
Significant Difference ◽  
Meta Analyses ◽  
The Impact

BACKGROUND: Transitions of care can contribute to medication errors and other adverse drug events. PURPOSE: The aim of this study was to evaluate the impact of pharmacist-led discharge counseling on hospital readmission and emergency department visits through a systematic review and meta-analysis. DATA SOURCES: Electronic searches were performed in PubMed, Scopus, and DOAJ (Directory of Open Access Journals), along with a manual search (July 2017). PROSPERO registration no. CRD42017068444. STUDY SELECTION: Two independent reviewers performed all the steps of the systematic review process (screening of titles and abstracts, full-text appraisal, data extraction, and quality assessment), with contributions from a third researcher. We included randomized controlled trials (RCTs) reporting data on pharmacist-led discharge counseling. DATA EXTRACTION: Primary extracted outcomes were emergency department visits and hospital readmission rates. DATA SYNTHESIS: Meta-analyses of intervention versus usual care for hospital readmission and emergency department visit rates were performed using the inverse variance method. Results are reported as risk ratios (RRs) with 95% confidence intervals (CIs). Prediction intervals (PIs) were also calculated. Sensitivity and subgroup analyses were performed. A total of 21 RCTs were included in the qualitative synthesis and 18 in the meta-analyses (n = 7,244 patients). The original meta-analysis revealed a significant difference in the impact between pharmacist-led discharge counseling and usual care on overall hospital readmission (RR = 0.864 [95% CI 0.763-0.997], P = .020) and emergency department (RR = 0.697 [95% CI 0.535-0.907], P = .007) visits. However, the small number of included studies, the high heterogeneity among trials (I2 between 40% and 60%), and the wide PIs (hospital readmission: PI 0.542-1.186; emergency department visits: PI 0.027-1.367) prevented drawing further conclusions. CONCLUSIONS: Insufficient evidence exists regarding the effect of pharmacist-led discharge counseling on hospital readmission and emergency department visits. Further well-designed clinical trials with defined core outcome sets are needed.

The impact of PM2.5 on asthma emergency department visits: a systematic review and meta-analysis

2015 ◽  
Vol 23 (1) ◽  
pp. 843-850 ◽  
Author(s):  
Jingchun Fan ◽  
Shulan Li ◽  
Chunling Fan ◽  
Zhenggang Bai ◽  
Kehu Yang
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Meta Analysis ◽  
Emergency Department Visits ◽  
The Impact

Hospitalisations and emergency department visits in cancer patients receiving systemic therapy: Systematic review and meta-analysis

2018 ◽  
Vol 28 (1) ◽  
pp. e12909 ◽  
Author(s):  
Rebecca M. Prince ◽  
Melanie Powis ◽  
Alona Zer ◽  
Eshetu G. Atenafu ◽  
Monika K. Krzyzanowska
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Cancer Patients ◽  
Systemic Therapy ◽  
Meta Analysis ◽  
Emergency Department Visits

scholarly journals Transitional care models for chronic patients: preliminary results from an umbrella review

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M T Riccardi ◽  
M Cicconi ◽  
W Ricciardi ◽  
M M Gianino ◽  
G Damiani
Keyword(s):  
Emergency Department ◽  
Usual Care ◽  
Hospital Readmission ◽  
Readmission Rate ◽  
Care Setting ◽  
Transitional Care ◽  
Emergency Department Visits ◽  
Current Evidence ◽  
Chronic Patients ◽  
Care Models

Abstract Worldwide, chronic diseases are burdening and the health systems need to be rethought to better manage this epidemiologic shift. One of the critical points in the care pathway of chronic patients is the transition from one care setting to another. Aim of this study is to provide an overview of the current evidence on the impact of transitional care programs on health and economic outcomes for chronic patients Medline, Web of Science and EMBASE were queried for relevant reviews using the Population-Intervention-Context-Outcome (PICO) model. The quality of the included articles was determined using A MeaSurement Tool to Assess systematic Reviews (AMSTAR 2). Data were analyzed using descriptive statistic, and comparison among studies carried out in European Union (EU) versus non-EU was performed (Chi-square test was used and a p < 0.05 was deemed as statistically significant) 124 reviews were assessed for eligibility and 14 were eventually included (for a total of 167 primary articles). Quality appraisal was critically low in 60% of the reviews. Both hospital readmission rate and Emergency Department (ED) visit rate were lower than those in usual care group, but this difference was significant in 40% of articles. In EU studies readmission rate was lower in 65% of cases while in non-EU ones the percentage was 51.0%, but the difference was not significant (p = 0.23). Six reviews (43%) investigated the economic impact of the transitional care: most reported an initial increase in cost due to investment in staff training and creation of organizational networks, followed by a sharp decrease in costs due to a better utilization of health services, thus leading to a reduction in overall costs. Compared with usual care, transitional care shows an overall cost reduction, even if with limited effects on re-hospitalization or ED visit rates. These findings should encourage decision makers to invest in the development of this kind of programs in order to identify models that best perform. Key messages The patient transfer supervision from one care setting to another is necessary for continuity of care, but there is no robust evidence about the better performance of transitional care models. Systematically reviewed transitional care models has been shown be more cost saving, with a moderate impact on hospital readmission or emergency department visits rates.

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