Background

The German hospital-to-home discharge management of geriatric patients has long been criticized. The implementation of the American Transitional Care Model (TCM) could help to reduce readmissions and costs. The objective of this review was to check the scientific evidence of the cost-effectiveness of the TCM.

Methods

A systematic literature search in six databases for the time period of 26 years was conducted. The studies had to meet all pre-defined inclusion criteria. The data extraction is based on a criteria chart from literature. The methodological quality was assessed using the tools of the National Heart, Lung, and Blood Institute as well as the Consensus Health Economic Criteria list. The results transferability to German health care system was explained based on the criteria from the literature.

Results

Three American studies met all criteria. They showed partial cost analyses but no full economic analyses. It could be assumed that the economic effect of the TCM changes over time. The costs of a care coordinator could not be determined because few detailed information was reported. The TCM may have negative consequences for hospitals. The results are not transferable to Germany.

Conclusion

There is no scientific evidence for the cost-effectiveness of the defined TCM. The optimal TCM duration still needs to be clarified. A detailed overview with units and prices and an additional consideration of the hospital perspective could help to make the information more transparent when deciding about the TCM implementation. A full economic analysis under German conditions or for similar European countries is necessary.

中文翻译：

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老年患者出院到家中过渡护理模式成本效益的经济证据：系统评价

背景

德国对老年患者的医院到家出院管理长期以来一直饱受诟病。美国过渡性护理模式 (TCM) 的实施有助于降低再入院率和成本。本次审查的目的是检查中医成本效益的科学证据。

方法

在 6 个数据库中进行了 26 年的系统文献检索。这些研究必须满足所有预先确定的纳入标准。数据提取基于文献中的标准图表。使用国家心肺血液研究所的工具以及共识健康经济标准清单评估方法学质量。根据文献中的标准解释了结果向德国医疗保健系统的可转移性。

结果

三项美国研究符合所有标准。他们展示了部分成本分析，但没有进行全面的经济分析。可以假设中医的经济影响会随着时间而变化。由于报告的详细信息很少，因此无法确定护理协调员的费用。中医可能会对医院产生负面影响。结果不能转移到德国。

结论

没有科学证据证明定义的 TCM 的成本效益。最佳中医持续时间仍需明确。详细了解单位和价格以及对医院观点的额外考虑有助于在决定 TCM 实施时使信息更加透明。在德国或类似欧洲国家的情况下进行全面的经济分析是必要的。