Improvement of transfer between sectors

The objective of this study is to compare the effects of municipality-based and hospital-based interventions, both consisting of early post-discharge transitional care follow-up, in a population of frail geriatric patients. We hypothesised equal effects of the two follow-up methods on 30-day readmission, 90-day mortality and length of hospital stay.

Contact: Troels Kjærskov Hansen

Publication: Hansen TK, Pedersen LH, Shahla S, Damsgaard EM, Bruun JM, Gregersen M. Effects of a new early municipality-based versus a geriatric team-based transitional care intervention on readmission and mortality among frail older patients - a randomised controlled trial. Arch Gerontol Geriatr. 2021. doi: 10.1016/j.archger.2021.104511. Epub 2021 Aug 26. PMID: 34479071.

Impact of transitional care interventions on unplanned hospital readmissions

The objectives of this study are to

• identify, assess and synthesize the existing literature on the effects of discharge interventions aiming to reduce readmissions in the transitional phase between hospital and home of elderly patients discharged from a medical ward
• determine the effect of a hospital-based discharge intervention in the transitional phase between hospital and home on readmission rates and mortality among elderly patients discharged from a medical ward
• identify multilevel factors that contribute to readmissions evaluated by patients and their relative, community-based nurses, general practitioners (GP) and hospital doctors

Contact: Lisa Fønss Rasmussen

Publication: Fønss Rasmussen L, Grode LB, Lange J, Barat I, Gregersen M. Impact of transitional care interventions on hospital readmissions in older medical patients: a systematic review. BMJ Open. 2021 Jan 8;11(1):e040057. doi: 10.1136/bmjopen-2020-040057. PMID: 33419903; PMCID: PMC7799140.