{"title":"避免住院在家作为老年人常规医院护理替代的有效性：一项系统回顾和荟萃分析","authors":"Mengyuan Cheng , Lulu Lin , Xiaowen Cao , Weiming Tang , Xin Xu , Xiaoxue Zhang , Yongshun Huang , Junzhang Tian , Zhongzhi Xu , Weibin Cheng","doi":"10.1016/j.glt.2025.06.002","DOIUrl":null,"url":null,"abstract":"<div><div>This systematic review and meta-analysis aimed to assess the effectiveness of home-based programmes to prevent hospital admissions compared with traditional hospital-based care for older adults. Health outcomes analysed included readmission rates, mortality, and length of treatment. Data from 15 studies were synthesised using Review Manager (version 5.4), and heterogeneity was assessed using forest plots and <em>I</em><sup>2</sup>statistics. Subgroup analyses were performed for randomised controlled trials and for specific patient groups, such as those with cardiovascular and respiratory disease. The results suggest that hospital at home programmes may reduce the risk of readmission (risk ratio = 0.76, 95 % CI 0.58 to 1.01, P = 0.05), especially for patients with respiratory diseases (risk ratio = 0.53, 95 % CI 0.39 to 0.73, P = 0.00007), with no significant differences in mortality or treatment duration between groups.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"7 ","pages":"Pages 342-349"},"PeriodicalIF":3.1000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of admission-avoidance hospital at home as alternative to routine hospital care in older adults: a systematic review and meta-analysis\",\"authors\":\"Mengyuan Cheng , Lulu Lin , Xiaowen Cao , Weiming Tang , Xin Xu , Xiaoxue Zhang , Yongshun Huang , Junzhang Tian , Zhongzhi Xu , Weibin Cheng\",\"doi\":\"10.1016/j.glt.2025.06.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>This systematic review and meta-analysis aimed to assess the effectiveness of home-based programmes to prevent hospital admissions compared with traditional hospital-based care for older adults. Health outcomes analysed included readmission rates, mortality, and length of treatment. Data from 15 studies were synthesised using Review Manager (version 5.4), and heterogeneity was assessed using forest plots and <em>I</em><sup>2</sup>statistics. Subgroup analyses were performed for randomised controlled trials and for specific patient groups, such as those with cardiovascular and respiratory disease. The results suggest that hospital at home programmes may reduce the risk of readmission (risk ratio = 0.76, 95 % CI 0.58 to 1.01, P = 0.05), especially for patients with respiratory diseases (risk ratio = 0.53, 95 % CI 0.39 to 0.73, P = 0.00007), with no significant differences in mortality or treatment duration between groups.</div></div>\",\"PeriodicalId\":33615,\"journal\":{\"name\":\"Global Transitions\",\"volume\":\"7 \",\"pages\":\"Pages 342-349\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Global Transitions\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2589791825000258\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"Social Sciences\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Global Transitions","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2589791825000258","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Social Sciences","Score":null,"Total":0}
引用次数: 0
摘要
本系统综述和荟萃分析旨在评估以家庭为基础的方案与传统的以医院为基础的老年人护理相比预防住院的有效性。分析的健康结果包括再入院率、死亡率和治疗时间。使用Review Manager （version 5.4）对来自15项研究的数据进行综合，并使用森林样地和i2统计来评估异质性。对随机对照试验和特定患者组（如心血管和呼吸系统疾病患者）进行亚组分析。结果表明，居家医院方案可降低再入院风险（风险比= 0.76,95% CI 0.58 ~ 1.01, P = 0.05），特别是呼吸道疾病患者（风险比= 0.53,95% CI 0.39 ~ 0.73, P = 0.00007），两组之间的死亡率或治疗时间无显著差异。
Effectiveness of admission-avoidance hospital at home as alternative to routine hospital care in older adults: a systematic review and meta-analysis
This systematic review and meta-analysis aimed to assess the effectiveness of home-based programmes to prevent hospital admissions compared with traditional hospital-based care for older adults. Health outcomes analysed included readmission rates, mortality, and length of treatment. Data from 15 studies were synthesised using Review Manager (version 5.4), and heterogeneity was assessed using forest plots and I2statistics. Subgroup analyses were performed for randomised controlled trials and for specific patient groups, such as those with cardiovascular and respiratory disease. The results suggest that hospital at home programmes may reduce the risk of readmission (risk ratio = 0.76, 95 % CI 0.58 to 1.01, P = 0.05), especially for patients with respiratory diseases (risk ratio = 0.53, 95 % CI 0.39 to 0.73, P = 0.00007), with no significant differences in mortality or treatment duration between groups.
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