Unplanned hospital admissions (UHA) are a problem for health systems internationally as they are costly and disruptive to elective health care, and increase waiting lists. The overall aim of this series of systematic reviews was to evaluate the effectiveness and cost-effectiveness of interventions to reduce UHA.
“This review represents one of the most comprehensive sources of evidence on interventions for unplanned hospital admissions. There was evidence that education/self-management, exercise/rehabilitation and telemedicine in selected patient populations, and specialist heart failure interventions can help reduce unplanned admissions. However, the evidence to date suggests that majority of the remaining interventions included in these reviews do not help reduce unplanned admissions in a wide range of patients. There was insufficient evidence to determine whether home visits, pay by performance schemes, A & E services and continuity of care reduce unplanned admissions.
The results of this review are important for policy makers, clinicians and researchers. Some of the findings may be disappointing but it is important to remember that some of the interventions may have demonstrable impact in other areas, for example case management appears to reduce length of hospital stay. In addition, in many health care economies a number of interventions are introduced across the system. Few research studies include evaluation of system wide approaches, hence the impact of programmes of interventions are rarely reported in the research literature. This highlights the importance of robust evaluation of interventions as they are introduced into health and social care systems” p8
See the report: Interventions to reduce unplanned hospital admission: a series of systematic reviews. Universities of Bristol and Cardiff. June 2012. Funded by National Institute for Health Research