Systematic Review and Meta-analysis of Geriatric Specialist Health Care Team Implementations to Reduce Hospital Bed Days for Older Adult Inpatients with Dementia and Cognitive Disorders

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  • 認知症および認知機能低下者を含む高齢入院患者群への老年専門職チームによる介入の在院日数短縮等への有効性 : システマティックレビューとメタアナリシス

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Abstract

[Purpose] This systematic review and meta-analysis evaluated the effects of Gerontological specialist healthcare team implementations to reduce hospital bed days, and other clinical outcomes for older adult inpatients with dementia and cognitive disorders, and compared them with the effects of conventional standard healthcare. [Method] An extensive literature search of several databases was performed in July, 2014 that included both Japanese and English articles. The articles were categorized as: i) randomized controlled trials, ii) intervention performed in the hospital for older adults aged ≥65, iii) screened subject's cognitive status using MMSE or other scales, or diagnosed dementia, iv) geriatric specialist healthcare team including assessment and implementations with more than two specialists such as gerontologists and gerontological nurse specialists, and were then evaluated. A random effects model was applied. Risk ratio and mean difference were calculated. Heterogeneity was assessed using the I2 statistic. [Results] Seven original articles involving 301〜999 participants were identified in the meta-analysis. Geriatric specialist healthcare team implementations for inpatients with dementia and cognitive disorder reduced the mean hospital bed days. However, it did not affect the mortality during admission, use of institutional services at discharge and during one year after discharge, and other clinical outcomes. [Conclusion] It was possible to conclude that Geriatric specialist healthcare team implementations for inpatients with dementia and cognitive disorder significantly reduce the mean hospital bed days; however, the evidence was shown to be limited.

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