Evidence map›Paper›PMID 32103745›Full record

ArticleBMC palliative care2020

A scoping review of initiatives to reduce inappropriate or non-beneficial hospital admissions and bed days in people nearing the end of their life: much innovation, but limited supporting evidence.

Ros Taylor, Jonathan Ellis, Wei Gao, Liz Searle, Kate Heaps, Robert Davies, Claire Hawksworth, Angela Garcia-Perez, Giles Colclough, Steven Walker and 1 more

Abstract readScoping Review
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC palliative care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Observational
  6. Article
  7. Home infusion services in Saudi Arabia: Where are we standing?Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2023
    Review
  8. Article
  9. Article
  10. Article
  11. Review
  12. Article
  13. Review
  14. Article
  15. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Ros TaylorHospice UK, London, UK.
Jonathan EllisHospice UK, London, UK.
Wei GaoCicely Saunders Institute, London, UK.
Liz SearleKeech Hospice Care, Luton, UK.
Kate HeapsGreenwich & Bexley Hospice, London, UK.
Robert DaviesStgilesmedical Ltd, The Vestry House, St Giles High Street, London, WC2H 8LG, UK.
Claire HawksworthStgilesmedical Ltd, The Vestry House, St Giles High Street, London, WC2H 8LG, UK.
Angela Garcia-PerezStgilesmedical Ltd, The Vestry House, St Giles High Street, London, WC2H 8LG, UK.
Giles ColcloughMcKinsey & Company, London, UK.
Steven WalkerStgilesmedical Ltd, The Vestry House, St Giles High Street, London, WC2H 8LG, UK. steven.walker@stgmed.com.ORCID http://orcid.org/0000-0002-1259-6396
Bee WeeHarris Manchester College, University of Oxford, Oxford, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHospitalisation during the last weeks of life when there is no medical need or desire to be there is distressing and expensive. This study sought palliative care initiatives which may avoid or shorten hospital stay at the end of life and analysed their success in terms reducing bed days.

methodsPart 1 included a search of literature in PubMed and Google Scholar between 2013 and 2018, an examination of governmental and organisational publications plus discussions with external and co-author experts regarding other sources. This initial sweep sought to identify and categorise relevant palliative care initiatives. In Part 2, we looked for publications providing data on hospital admissions and bed days for each category.

resultsA total of 1252 abstracts were reviewed, resulting in ten broad classes being identified. Further screening revealed 50 relevant publications describing a range of multi-component initiatives. Studies were generally small and retrospective. Most researchers claim their service delivered benefits. In descending frequency, benefits identified were support in the community, integrated care, out-of-hours telephone advice, care home education and telemedicine. Nurses and hospices were central to many initiatives. Barriers and factors underpinning success were rarely addressed.

conclusionsA wide range of initiatives have been introduced to improve end-of-life experiences. Formal evidence supporting their effectiveness in reducing inappropriate/non-beneficial hospital bed days was generally limited or absent.

trial registrationN/A.

Indexed as

HospitalizationHumansLength of StayPatient AdmissionQuality of Health CareTerminal CareHome careHospital careNursing home carePalliative careService evaluationSupportive care

Identifiers

PMID32103745
PMCPMC7045380

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.