Hospital-to-home transitions for children with medical complexity: part 1, a systematic review of reported outcomes

Outcome selection to evaluate interventions to support a successful transition from hospital to home of children with medical complexity (CMC) may be difficult due to the variety in available outcomes. To support researchers in outcome selection, this systematic review aimed to summarize and categorize outcomes currently reported in publications evaluating the effectiveness of hospital-to-home transitional care interventions for CMC. We searched the following databases: Medline, Embase, Cochrane library, CINAHL, PsychInfo, and Web of Science for studies published between 1 January 2010 and 15 March 2023. Two reviewers independently screened the articles and extracted the data with a focus on the outcomes. Our research group extensively discussed the outcome list to identify those with similar definitions, wording or meaning. Consensus meetings were organized to discuss disagreements, and to summarize and categorize the data. We identified 50 studies that reported in total 172 outcomes. Consensus was reached on 25 unique outcomes that were assigned to six outcome domains: mortality and survival, physical health, life impact (the impact on functioning, quality of life, delivery of care and personal circumstances), resource use, adverse events, and others. Most frequently studied outcomes reflected life impact and resource use. Apart from the heterogeneity in outcomes, we also found heterogeneity in designs, data sources, and measurement tools used to evaluate the outcomes.

Conclusion: This systematic review provides a categorized overview of outcomes that may be used to evaluate interventions to improve hospital-to-home transition for CMC. The results can be used in the development of a core outcome set transitional care for CMC.

Contributors

Annemieke de Lange, Mattijs W. Alsem, Heleen N. Haspels, Clara D. M. van Karnebeek, Job B. M. van Woensel, Faridi S. Etten–Jamaludin & Jolanda M. Maaskant

Publication

Journal: European Journal of Pediatrics
Volume:
Issue:
Pages: -
Year: 2023
DOI: 10.1007/s00431-023-05050-9

Further Study Information

Current Stage: Completed
Date:
Funding source(s): This project is made possible by the Foundation “Steun Emma Kinderziekenhuis” and The Netherlands Organisation for Health Research and Development (ZonMw; 845008701). Both funders had no role in the design and conduct of the study.


Health Area

Disease Category: Child health, Effective practice/health systems

Disease Name: Complex medical needs

Target Population

Age Range: 18

Sex: Either

Nature of Intervention: Management of care

Stakeholders Involved

Study Type

- Systematic review of outcomes measured in trials

Method(s)

- Systematic review

We searched Medline, EMBASE, Cochrane library, CINAHL, PsychInfo and Web of Science with help of a clinical librarian. The search was limited to articles published in English between 1 January 2010 and 15 March 2023. The search was executed on 15 November 2020, and
updated on 18 March 2023.