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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Predicting discharge to institutional long-term care following acute hospitalisation: a systematic review and meta-analysis
Author(s): Harrison, Jennifer Kirsty
Walesby, Katherine E
Hamilton, Lorna
Armstrong, Carolyn
Starr, John M
Reynish, Emma
MacLullich, Alasdair M J
Quinn, Terry J
Shenkin, Susan D
Keywords: long-term care
care home
older people
Issue Date: Jul-2017
Citation: Harrison JK, Walesby KE, Hamilton L, Armstrong C, Starr JM, Reynish E, MacLullich AMJ, Quinn TJ & Shenkin SD (2017) Predicting discharge to institutional long-term care following acute hospitalisation: a systematic review and meta-analysis, Age and Ageing, 46 (4), pp. 547-558.
Abstract: Background  moving into long-term institutional care is a significant life event for any individual. Predictors of institutional care admission from community-dwellers and people with dementia have been described, but those from the acute hospital setting have not been systematically reviewed. Our aim was to establish predictive factors for discharge to institutional care following acute hospitalisation.  Methods  we registered and conducted a systematic review (PROSPERO: CRD42015023497). We searched MEDLINE; EMBASE and CINAHL Plus in September 2015. We included observational studies of patients admitted directly to long-term institutional care following acute hospitalisation where factors associated with institutionalisation were reported.  Results  from 9,176 records, we included 23 studies (n= 354,985 participants). Studies were heterogeneous, with the proportions discharged to a care home 3–77% (median 15%). Eleven studies (n= 12,642), of moderate to low quality, were included in the quantitative synthesis. The need for institutional long-term care was associated with age (pooled odds ratio (OR) 1.02, 95% confidence intervals (CI): 1.00–1.04), female sex (pooled OR 1.41, 95% CI: 1.03–1.92), dementia (pooled OR 2.14, 95% CI: 1.24–3.70) and functional dependency (pooled OR 2.06, 95% CI: 1.58–2.69).  Conclusions  discharge to long-term institutional care following acute hospitalisation is common, but current data do not allow prediction of who will make this transition. Potentially important predictors evaluated in community cohorts have not been examined in hospitalised cohorts. Understanding these predictors could help identify individuals at risk early in their admission, and support them in this transition or potentially intervene to reduce their risk.
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Rights: © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

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