Organising health care services for people with an acquired brain injury: an overview of systematic reviews and randomised controlled trials

BMC Health Services Research

Russell Gruen⁶  Robert Teasell⁵  Fary Khan¹  Denise O’Connor⁹  Emma Tavender⁷  Anne E Holland³  Peter Hunter²  Peter Bragge⁶  Natasha A Lannin⁸  Kate Laver⁴ 

[1] Department of Rehabilitation Medicine, The University of Melbourne, Melbourne, Australia;Rehabilitation, Aged and Community Care, Alfred Health, Melbourne, VIC, Australia;Physiotherapy, Alfred Health, Melbourne, VIC, Australia;Occupational Therapy, La Trobe University, Melbourne, VIC, Australia;Physical Medicine and Rehabilitation, University of Western Ontario, ON, Canada;National Trauma Research Institute, Monash University and The Alfred Hospital, VIC, Australia;Australian Satellite of the Cochrane Effective Practice and Organisation of Care (EPOC) Group', Monash University, Melbourne, Australia;Occupational Therapy, Alfred Health, Melbourne, VIC, Australia;School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

关键词: Quality assurance (Health Care);    Delivery of health care;    Case management;    Rehabilitation;    Systematic review;    Stroke;    Craniocerebral trauma;    Brain injuries;   

Others  :  1126424
DOI  :  10.1186/1472-6963-14-397

 received in 2014-02-20, accepted in 2014-09-05,  发布年份 2014

【 摘 要 】

Background

Acquired brain injury (ABI) is the leading cause of disability worldwide yet there is little information regarding the most effective way to organise ABI health care services. The aim of this review was to identify the most up-to-date high quality evidence to answer specific questions regarding the organisation of health care services for people with an ABI.

Methods

We conducted a systematic review of English papers using MEDLINE, EMBASE, PsycINFO, CINAHL and the Cochrane Library. We included the most recently published high quality systematic reviews and any randomised controlled trials, non-randomised controlled trials, controlled before after studies or interrupted time series studies published subsequent to the systematic review. We searched for papers that evaluated pre-defined organisational interventions for adults with an ABI. Organisational interventions of interest included fee-for-service care, integrated care, integrated care pathways, continuity of care, consumer engagement in governance and quality monitoring interventions. Data extraction and appraisal of included reviews and studies was completed independently by two reviewers.

Results

A total of five systematic reviews and 21 studies were included in the review; eight of the papers (31%) included people with a traumatic brain injury (TBI) or ABI and the remaining papers (69%) included only participants with a diagnosis of stroke. We found evidence supporting the use of integrated care to improve functional outcome and reduce length of stay and evidence supporting early supported discharge teams for reducing morbidity and mortality and reducing length of stay for stroke survivors. There was little evidence to support case management or the use of integrated care pathways for people with ABI. We found evidence that a quality monitoring intervention can lead to improvements in process outcomes in acute and rehabilitation settings. We were unable to find any studies meeting our inclusion criteria regarding fee-for-service care or engaging consumers in the governance of the health care organisation.

Conclusions

The review found evidence to support integrated care, early supported discharge and quality monitoring interventions however, this evidence was based on studies conducted with people following stroke and may not be appropriate for all people with an ABI.

【 授权许可】

   
2014 Laver et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Australian Bureau of Statistics: Disability, ageing and carers: summary of findings, Australia. In ABS cat no 4430.0. ABS: Canberra; 2004.
• [2]Faul M, Xu L, Wald M, Coronado V: Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Atlanta: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2010.
• [3]Key facts and statistics: Key facts and statistics. https://www.headway.org.uk/key-facts-and-statistics.aspx webcite
• [4]Australian Institute of Health and Welfare: National community services data dictionary. In Cat. no. HWI 91. Canberra: AIHW; 2006.
• [5]Turner-Stokes L, Wade D: Rehabilitation following acquired brain injury: concise guidance. Clin Med 2004, 4(1):61-65.
• [6]Cramer C, Sur M, Dobkin B, O'Brien C, Sanger T, Trojanowski J, Rumsey J, Hicks R, Cameron J, Chen D, Chen W, Cohen L, DeCharms C, Duffy C, Eden G, Fetz E, Filart R, Freund M, Grant S, Haber S, Kalivas P, Kolb B, Kramer A, Lynch M, Mayberg H, McQuillen P, Nitkin R, Pascual-Leone A, Reuter L, Schiff N, et al.: Harnessing neuroplasticity for clinical applications. Brain 2011, 134(6):1591-1609.
• [7]Stein S, Georgoff P, Meghan S, Mirza K, Sonnad SS: 150 years of treating severe traumatic brain injury: A systematic review of progress in mortality. J Neurotrauma 2010, 27(7):1343-1353.
• [8]Stroke Unit Trialists’ Collaboration: Organised inpatient (stroke unit) care for stroke. Cochrane Database Syst Rev 2007, (4):CD000197. Art. No.: CD000197. doi:10.1002/14651858.CD000197.pub2
• [9]ERABI: Evidence-Based Review of Moderate to Severe Acquired Brain Injury. 2012.
• [10]Laver K, Lannin N, O'Connor D, Bragge P, Hunter P, Khan F, Holland A, Teasell R, Gruen R: Organising health care services for people with an acquired brain injury requiring acute care or rehabilitation services. PROSPERO 2013.
• [11]Shea B, Grimshaw J, Wells G, Boers M, Andersson N, Hamel C, Porter A, Tugwell P, Moher D, Bouter L: Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviewa. BMC Med Res Methodol 2007., 7(10)
• [12]Moseley A, Herbert R, Sherrington C, Maher C: Evidence for physiotherapy practice: a survey of the Physiotherapy Evidence Database (PEDro). Aust J Physiother 2002, 48:43-49.
• [13]Downs S, Black N: The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health 1998, 52:377-384.
• [14]Indredavik B, Fjaertoft H, Ekeberg G, Loge A, Morch B: Benefit of an extended stroke unit service with early supported discharge: a randomized, controlled trial. Stroke 2000, 31(12):2989-2994.
• [15]vanHolmqvist L, vVon KL, Kostulas V, Holm M, Widsell G, Tegler H, Johansson K, Almazan J, de Pedro-Cuesta J: A randomized controlled trial of rehabilitation at home after stroke in southwest Stockholm. Stroke 1998, 29(3):591-597.
• [16]Kalra L, Evans A, Perez I, Knapp M, Donaldson N, Swift C: Alternative strategies for stroke: a prospective randomised controlled trial. Lancet 2000, 356:894-899.
• [17]Kwan J, Sandercock P: In-hospital care pathways for stroke. Cochr Database Syst Rev (Online) 2004, 2:CD002924.
• [18]Middleton S, McElduff P, Ward J, Grimshaw JM, Dale S, D'Este C, Drury P, Griffiths R, Cheung NW, Quinn C, Evans M, Cadilhac D, Levi C, QASC Trialists Group: Implementation of evidence-based treatment protocols to manage fever, hyperglycaemia, and swallowing dysfunction in acute stroke (QASC): a cluster randomised controlled trial. Lancet 2011, 378(9804):1699-1706.
• [19]Sulch D, Perez I, Melbourn A, Kalra L: Randomized controlled trial of Integrated (managed) Care Pathway for stroke rehabilitation. Stroke 2000, 31(8):1929-1934.
• [20]Falconer JA, Roth EJ, Sutin JA, Strasser DC, Chang RW: The critical path method in stroke rehabilitation: lessons from an experiment in cost containment and outcome improvement. QRB Qual Rev Bull 1993, 19(1):8-16.
• [21]Odderson I, McKenna B: A model for management of patients with stroke during the acute phase: Outcome and economic implications. Stroke 1993, 24:1823-1827.
• [22]Ross G, Johnson D, Kobernick M: Evaluation of a critical pathway for stroke. J Am Osteopath Assoc 1997, 97(5):269-276.
• [23]Ellis G, Mant J, Langhorne P, Martin D, Winner S: Stroke liason workers for stroke patients and carers: an individual patient data meta-analysis. Cochrane Database Syst Rev 2010., 5Art. No.: CD005066. doi:10.1002/14651858.CD005066.pub2
• [24]Allen K, Hazelett S, Jarjoura D, Hua K, Wright K, Weinhardt J, Kropp D: A randomized trial testing the superiority of a postdischarge care management model for stroke survivors. J Stroke Cerebrovasc Dis 2009, 18(6):443-452.
• [25]Patterson PK, Maynard H, Chesnut RM, Carney N, Mann NC, Helfand M: Evidence of case management effect on traumatic-brain-injured adults in rehabilitation. Care Manag J 1999, 1(2):87-97.
• [26]Bell K, Brockway J, Hart T, Whyte J, Sherer M, Fraser R, Temkin N, Dikmen S: Scheduled telephone intervention for traumatic brain injury: a multicenter randomized controlled trial. Arch Phys Med Rehabil 2011, 92(10):1552-1560.
• [27]Bell K, Hoffman J, Temkin N, Powell J, Fraser R, Esselman P, Barber J, Dikmen S: The effect of telephone counselling on reducing post-traumatic symptoms after mild traumatic brain injury: a randomised trial. J Neurol Neurosurg Psychiatry 2008, 79(11):1275-1281.
• [28]Bell KR, Temkin NR, Esselman PC, Doctor JN, Bombardier CH, Fraser RT, Hoffman JM, Powell JM, Dikmen S: The effect of a scheduled telephone intervention on outcome after moderate to severe traumatic brain injury: a randomized trial. Arch Phys Med Rehabil 2005, 86(5):851-856.
• [29]Trexler LE, Trexler LC, Malec JF, Klyce D, Parrott D: Prospective randomized controlled trial of resource facilitation on community participation and vocational outcome following brain injury. J Head Trauma Rehabil 2010, 25(6):440-446.
• [30]Fearon P, Langhorne P, Early Supported Discharge Trialists: Services for reducing duration of hospital care for acute stroke patients. Cochrane Database Syst Rev 2012., 9Art. No.: CD000443. doi:10.1002/14651858.CD000443.pub3
• [31]Andersen H, Schultz-Larsen K, Kreiner S, Forchhammer B, Eriksen K, Brown A: Can readmission after stroke be prevented? Results of a randomized clinical study: a postdischarge follow-up service for stroke survivors. Stroke 2000, 31(5):1038-1045.
• [32]Forster A, Young J, Green J, Patterson C, Wanklyn P, Smith J, Murray J, Wild H, Bogle S, Lowson K: Structured re-assessment system at 6 months after a disabling stroke: a randomised controlled trial with resource use and cost study. Age Ageing 2009, 38(5):576-583.
• [33]Ghaffar O, McCullagh S, Ouchterlony D, Feinstein A: Randomized treatment trial in mild traumatic brain injury. J Psychosom Res 2006, 61(2):153-160.
• [34]Wade DT, Crawford S, Wenden FJ, King N, Moss NE: Does routine follow up after head injury help? A randomised controlled trial. J Neurol Neurosurg Psychiatry 1997, 62(5):478-484.
• [35]Wade DT, King NS, Wenden FJ, Crawford S, Caldwell FE: Routine follow up after head injury: a second randomised controlled trial. J Neurol Neurosurg Psychiatry 1998, 65(2):177-183.
• [36]Ytterberg C, Anderson M, Britton M: How do stroke patients fare when discharged straight to their homes? A controlled study on the significance of hospital follow-up after one month. Scand J Rehabil Med 2000, 32(2):93-96.
• [37]Parker C, Schwamm LH, Fonarow GC, Smith EE, Reeves MJ: Stroke quality metrics: systematic reviews of the relationships to patient-centered outcomes and impact of public reporting. Stroke 2012, 43(1):155-162.
• [38]Dirks M, Baeten SA, Dippel DW, van Exel NJ, van Wijngaarden JD, Huijsman R, Koudstaal PJ, Niessen LW, Practise I: Real-life costs and effects of an implementation program to increase thrombolysis in stroke. Neurology 2012, 79(6):508-514.
• [39]Johnston SC, Sidney S, Hills NK, Grosvenor D, Klingman JG, Bernstein A, Levin E: Standardized discharge orders after stroke: results of the quality improvement in stroke prevention (QUISP) cluster randomized trial. Ann Neurol 2010, 67(5):579-589.
• [40]Lakshminarayan K, Borbas C, McLaughlin B, Morris NE, Vazquez G, Luepker RV, Anderson DC: A cluster-randomized trial to improve stroke care in hospitals. Neurology 2010, 74(20):1634-1642.
• [41]Strasser DC, Falconer JA, Stevens AB, Uomoto JM, Herrin J, Bowen SE, Burridge AB: Team training and stroke rehabilitation outcomes: a cluster randomized trial. Arch Phys Med Rehabil 2008, 89(1):10-15.
• [42]Hinchey JA, Shephard T, Tonn ST, Ruthazer R, Hermann RC, Selker HP, Kent DM: The Stroke Practice Improvement Network: a quasiexperimental trial of a multifaceted intervention to improve quality. J Stroke Cerebrovasc Dis 2010, 19(2):130-137.
• [43]Schull D, Tosch P, Wood M: Clinical nurse specialists as collaborative care managers. Nurs Manage 1992, 23:30-33.
• [44]GRADE Working Group: Grading quality of evidence and strength of recommendations. BMJ 2004, 328(7454):1490.