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Admission avoidance hospital at home

Overview of attention for article published in Cochrane database of systematic reviews, September 2016
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (97th percentile)
  • High Attention Score compared to outputs of the same age and source (93rd percentile)

Mentioned by

news
6 news outlets
policy
2 policy sources
twitter
55 tweeters

Citations

dimensions_citation
69 Dimensions

Readers on

mendeley
192 Mendeley
citeulike
1 CiteULike
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Title
Admission avoidance hospital at home
Published in
Cochrane database of systematic reviews, September 2016
DOI 10.1002/14651858.cd007491.pub2
Pubmed ID
Authors

Sasha Shepperd, Steve Iliffe, Helen A Doll, Mike J Clarke, Lalit Kalra, Andrew D Wilson, Daniela C. Gonçalves-Bradley

Abstract

Admission avoidance hospital at home provides active treatment by healthcare professionals in the patient's home for a condition that otherwise would require acute hospital inpatient care, and always for a limited time period. This is the third update of the original review. To determine the effectiveness and cost of managing patients with admission avoidance hospital at home compared with inpatient hospital care. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, two other databases, and two trials registers on 2 March 2016. We checked the reference lists of eligible articles. We sought unpublished studies by contacting providers and researchers who were known to be involved in the field. Randomised controlled trials recruiting participants aged 18 years and over. Studies comparing admission avoidance hospital at home with acute hospital inpatient care. We followed the standard methodological procedures expected by Cochrane and the Effective Practice and Organisation of Care (EPOC) Group. We performed meta-analysis for trials that compared similar interventions and reported comparable outcomes with sufficient data, requested individual patient data from trialists, and relied on published data when this was not available. We used the GRADE approach to assess the certainty of the body of evidence for the most important outcomes. We included 16 randomised controlled trials with a total of 1814 participants; three trials recruited participants with chronic obstructive pulmonary disease, two trials recruited participants recovering from a stroke, six trials recruited participants with an acute medical condition who were mainly elderly, and the remaining trials recruited participants with a mix of conditions. We assessed the majority of the included studies as at low risk of selection, detection, and attrition bias, and unclear for selective reporting and performance bias. Admission avoidance hospital at home probably makes little or no difference on mortality at six months' follow-up (risk ratio (RR) 0.77, 95% confidence interval (CI) 0.60 to 0.99; P = 0.04; I(2) = 0%; 912 participants; moderate-certainty evidence), little or no difference on the likelihood of being transferred (or readmitted) to hospital (RR 0.98, 95% CI 0.77 to 1.23; P = 0.84; I(2) = 28%; 834 participants; moderate-certainty evidence), and may reduce the likelihood of living in residential care at six months' follow-up (RR 0.35, 95% CI 0.22 to 0.57; P < 0.0001; I(2) = 78%; 727 participants; low-certainty evidence). Satisfaction with healthcare received may be improved with admission avoidance hospital at home (646 participants, low-certainty evidence); few studies reported the effect on caregivers. When the costs of informal care were excluded, admission avoidance hospital at home may be less expensive than admission to an acute hospital ward (287 participants, low-certainty evidence); there was variation in the reduction of hospital length of stay, estimates ranged from a mean difference of -8.09 days (95% CI -14.34 to -1.85) in a trial recruiting older people with varied health problems, to a mean increase of 15.90 days (95% CI 8.10 to 23.70) in a study that recruited patients recovering from a stroke. Admission avoidance hospital at home, with the option of transfer to hospital, may provide an effective alternative to inpatient care for a select group of elderly patients requiring hospital admission. However, the evidence is limited by the small randomised controlled trials included in the review, which adds a degree of imprecision to the results for the main outcomes.

Twitter Demographics

The data shown below were collected from the profiles of 55 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 192 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 2 1%
Japan 1 <1%
Spain 1 <1%
South Africa 1 <1%
Unknown 187 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 35 18%
Student > Ph. D. Student 23 12%
Student > Bachelor 20 10%
Researcher 18 9%
Student > Doctoral Student 16 8%
Other 42 22%
Unknown 38 20%
Readers by discipline Count As %
Medicine and Dentistry 66 34%
Nursing and Health Professions 33 17%
Social Sciences 13 7%
Psychology 12 6%
Biochemistry, Genetics and Molecular Biology 7 4%
Other 18 9%
Unknown 43 22%

Attention Score in Context

This research output has an Altmetric Attention Score of 86. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 May 2020.
All research outputs
#239,526
of 15,328,829 outputs
Outputs from Cochrane database of systematic reviews
#531
of 11,172 outputs
Outputs of similar age
#7,646
of 265,265 outputs
Outputs of similar age from Cochrane database of systematic reviews
#11
of 176 outputs
Altmetric has tracked 15,328,829 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 11,172 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 22.7. This one has done particularly well, scoring higher than 95% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 265,265 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 97% of its contemporaries.
We're also able to compare this research output to 176 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 93% of its contemporaries.