Background Quality of aftercare can crucially impact health status of older patients and reduce the extra burden of unplanned healthcare resource utilisation. However, evidence of effectiveness of primary healthcare in supporting aftercare, especially for older patients after discharge are limited. Methods We searched for English articles of randomised controlled trials published between January 2000 and March 2022. All-cause hospital readmission rate and length of hospital stay were pooled using a random-effects model. Subgroup analyses were conducted to identify the relationship between intervention characteristics and the effectiveness on all-cause hospital readmission rate. Results A total of 30 studies with 11,693 older patients were included in the review. Compared with patients in the control group, patients in the intervention group had 32% less risk of hospital readmission within 30 days (RR = 0.68, P < 0.001, 95%CI: 0.56–0.84), and 17% within 6 months (RR = 0.83, P < 0.001, 95%CI: 0.75–0.92). According to the subgroup analysis, continuity of involvement of primary healthcare in aftercare had significant effect with hospital readmission rates (P < 0.001). Economic evaluations from included studies suggested that aftercare intervention was cost-effective due to the reduction in hospital readmission rate and risk of further complications. Conclusion Integrating primary healthcare into aftercare was designed not only to improve the immediate transition that older patients faced but also to provide them with knowledge and skills to manage future health problems. There is a pressing need to introduce interventions at the primary healthcare level to support long-term care.

中文翻译：

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三级医院老年患者出院后将初级卫生保健纳入后期护理的有效性——系统评价和荟萃分析

背景 善后护理的质量可以对老年患者的健康状况产生至关重要的影响，并减少计划外医疗资源使用的额外负担。然而，初级医疗保健在支持善后护理方面的有效性的证据有限，特别是对于出院后的老年患者。方法 我们检索了 2000 年 1 月至 2022 年 3 月期间发表的随机对照试验的英文文章。使用随机效应模型汇总了全因再入院率和住院时间。进行亚组分析以确定干预特征与全因再入院率的有效性之间的关系。结果 共纳入 30 项研究，涉及 11,693 名老年患者。与对照组患者相比，干预组患者在 30 天内再次入院的风险降低了 32%（RR = 0.68，P < 0.001，95% CI：0.56-0.84），在 6 个月内降低了 17%（RR = 0.83，P < 0.001 , 95% CI: 0.75–0.92)。根据亚组分析，初级医疗保健参与善后护理的连续性对再入院率有显着影响（P < 0.001）。纳入研究的经济评估表明，由于降低再入院率和进一步并发症的风险，善后干预具有成本效益。结论 将初级医疗保健纳入善后护理不仅旨在改善老年患者面临的即时过渡，而且还为他们提供管理未来健康问题的知识和技能。