ArticleBMC geriatrics2021
Understanding transitional care programs for older adults who experience delayed discharge: a scoping review.
Article in BMC geriatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 59 citations in OpenAlex.
- Transitional care programs for older adults moving from hospital to home in Canada: A systematic review of text and opinion.PloS one · 2024Pooled it
- The impact of facility-based transitional care programs on function and discharge destination for older adults with cognitive impairment: a systematic review.BMC geriatrics · 2022Pooled it
- A transitional care program in a technologically monitored in-hospital facility reduces the length of hospital stay and improves multidimensional frailty in older patients: a Randomized Clinical Trial.Aging clinical and experimental research · 2024Trial
- Experiences of frail Korean older adults and their families in a transitional care program: an exploratory qualitative study.International journal of qualitative studies on health and well-being · 2026Article
- Article
- Responsible AI for Predicting Delayed Hospital Discharge Among Older Adults: Development and Evaluation Study for Balancing Accuracy, Equity, and Explainability.JMIR medical informatics · 2026Article
- A Multi-Method Study to Develop and Pilot Test an Interprofessional Transitional Care Model for Frail Older Adults - AdvantAGE.Journal of advanced nursing · 2025Article
- Reengineering Patient Discharge with Lean Methodology and RED Framework: A Model for Safer, Faster, Patient-Centered Transitions.Global journal on quality and safety in healthcare · 2025Article
- Unpacking the dynamics of transitional care units in Ontario, Canada.The Gerontologist · 2025Article
- Characteristics and care trajectories of older patients in temporary stays in Denmark.European geriatric medicine · 2025Article
- Nurses' Experience Regarding Barriers to Providing Internet Plus Continuous Nursing: Mixed Methods Study.JMIR medical informatics · 2025Article
- Policy interventions for improving hospital-to-home transitions of care for older adults and informal caregivers: a qualitative study.Israel journal of health policy research · 2025Article
- Prevalence of Delayed Discharge Among Patients Admitted to the Internal Medicine Wards: A Cross-Sectional Study.Nursing reports (Pavia, Italy) · 2025Article
- Patient preferences and willingness to pay for transitional care in breast cancer: a discrete choice experiment.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Implementation of cross-sectoral rehabilitation in the Nordic countries: a scoping review.Frontiers in health services · 2025Review
- Associations Between Successful Home Discharge and Posthospitalization Care Planning: Cross-Sectional Ecological Study.JMIR formative research · 2024Article
- Effectiveness of the Sub-Acute Care for Frail Elderly (SAFE) Transitional Care Unit on Short-Term Functional Independence in Frail Older Patients Discharged from Hospital.Canadian geriatrics journal : CGJ · 2024Article
- Transitional Care Program in Reducing Acute Hospital Utilization in Singapore.Healthcare (Basel, Switzerland) · 2024Article
- Decoding the persistence of delayed hospital discharge: An in-depth scoping review and insights from two decades.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundMany hospitalized older adults cannot be discharged because they lack the health and social support to meet their post-acute care needs. Transitional care programs (TCPs) are designed to provide short-term and low-intensity restorative care to these older adults experiencing or at risk for delayed discharge. However, little is known about the contextual factors (i.e., patient, staff and environmental characteristics) that may influence the implementation and outcomes of TCPs. This scoping review aims to answer: 1) What are socio-demographic and/or clinical characteristics of older patients served by TCPs?; 2) What are the core components provided by TCPs?; and 3) What patient, caregiver, and health system outcomes have been investigated and what changes in these outcomes have been reported for TCPs?
methodsThe six-step scoping review framework and PRISMA-ScR checklist were followed. Studies were included if they presented models of TCPs and evaluated them in community-dwelling older adults (65+) experiencing or at-risk for delayed discharge. The data synthesis was informed by a framework, consistent with Donabedian's structure-process-outcome model.
resultsTCP patients were typically older women with multiple chronic conditions and some cognitive impairment, functionally dependent and living alone. The review identified five core components of TCPs: assessment; care planning and monitoring; treatment; discharge planning; and patient, family and staff education. The main outcomes examined were functional status and discharge destination. The results were discussed with a view to inform policy makers, clinicians and administrators designing and evaluating TCPs as a strategy for addressing delayed hospital discharges.
conclusionTCPs can influence outcomes for older adults, including returning home. TCPs should be designed to incorporate interdisciplinary care teams, proactively admit those at risk of delayed discharge, accommodate persons with cognitive impairment and involve care partners. Additional studies are required to investigate the contributions of TCPs within integrated health care systems.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.