BACKGROUND Hospitalisation 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. METHODS Part 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. RESULTS A 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. CONCLUSIONS A 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 REGISTRATION N/A.

中文翻译：

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一项旨在减少寿命即将结束的人们的不适当或非受益性医院住院和就寝天数的举措的范围概述：大量创新，但支持证据有限。

背景技术在生活的最后几周中，当没有医疗需要或不希望住院时，住院是令人痛苦和昂贵的。这项研究寻求姑息治疗措施，这些措施可以避免或缩短临终时的住院时间，并从减少卧床时间方面分析了其成功之处。方法第1部分包括在2013年至2018年之间在PubMed和Google Scholar中进行文献检索，对政府和组织出版物进行审查，以及与外部专家和合著者就其他来源进行的讨论。最初的扫描旨在确定相关的姑息治疗措施并对其进行分类。在第2部分中，我们寻找了提供有关每个类别的住院人数和就寝天数的数据的出版物。结果总共审查了1252个摘要，确定了十个广泛的类别。进一步的筛选显示了50篇相关出版物，描述了一系列多成分计划。研究一般较小且具有回顾性。大多数研究人员声称他们的服务带来了好处。所确定的收益递减的形式包括社区支持，综合护理，非工作时间的电话咨询，养老院教育和远程医疗。护士和招待所是许多计划的核心。阻碍成功的障碍和因素很少得到解决。结论已经采取了各种各样的措施来改善报废体验。支持它们减少不适当/非有益的医院就诊天数有效性的正式证据通常​​是有限的或不存在的。试用注册N / A。研究一般较小且具有回顾性。大多数研究人员声称他们的服务带来了好处。所确定的收益递减的形式包括社区支持，综合护理，非工作时间的电话咨询，养老院教育和远程医疗。护士和招待所是许多计划的核心。阻碍成功的障碍和因素很少得到解决。结论已经采取了各种各样的措施来改善报废体验。支持它们减少不适当/非有益的医院就诊天数有效性的正式证据通常​​是有限的或不存在的。试用注册N / A。研究一般较小且具有回顾性。大多数研究人员声称他们的服务带来了好处。所确定的收益递减的形式包括社区支持，综合护理，非工作时间的电话咨询，养老院教育和远程医疗。护士和招待所是许多计划的核心。阻碍成功的障碍和因素很少得到解决。结论已经采取了各种各样的措施来改善报废体验。支持它们减少不适当/非有益的医院就诊天数有效性的正式证据通常​​是有限的或不存在的。试用注册N / A。护理家庭教育和远程医疗。护士和招待所是许多计划的核心。阻碍成功的障碍和因素很少得到解决。结论已经采取了各种各样的措施来改善报废体验。支持它们减少不适当/非有益的医院就诊天数有效性的正式证据通常​​是有限的或不存在的。试用注册N / A。护理家庭教育和远程医疗。护士和招待所是许多计划的核心。阻碍成功的障碍和因素很少得到解决。结论已经采取了各种各样的措施来改善报废体验。支持它们减少不适当/非有益的医院就诊天数有效性的正式证据通常​​是有限的或不存在的。试用注册N / A。