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首页> 外文期刊>Journal of physiotherapy >Additional weekend allied health services reduce length of stay in subacute rehabilitation wards but their effectiveness and cost-effectiveness are unclear in acute general medical and surgical hospital wards: a systematic review
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Additional weekend allied health services reduce length of stay in subacute rehabilitation wards but their effectiveness and cost-effectiveness are unclear in acute general medical and surgical hospital wards: a systematic review

机译：一项周末回顾：额外的周末专职医疗服务减少了亚急性康复病房的住院时间，但对于急性普通内科和外科医院病房，其有效性和成本效益尚不明确：

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Question Are additional weekend allied health services effective and cost-effective for acute general medical and surgical wards, and subacute rehabilitation hospital wards? Design Systematic review and meta-analysis of studies published between January 2000 and May 2017. Two reviewers independently screened studies for inclusion, extracted data, and assessed methodological quality. Meta-analyses were conducted for relative measures of effect estimates. Participants Patients admitted to acute general medical and surgical wards, and subacute rehabilitation wards. Intervention All services delivered by allied health professionals during weekends (Saturday and/or Sunday). This study limited allied health professions to: occupational therapy, physiotherapy, social work, speech pathology, dietetics, art therapy, chiropractic, exercise physiology, music therapy, oral health (not dentistry), osteopathy, podiatry, psychology, and allied health assistants. Outcome measures Hospital length of stay, hospital re-admission, adverse events, discharge destination, functional independence, health-related quality of life, and cost of hospital care. Results Nineteen articles (20 studies) were identified, comprising 10 randomised and 10 non-randomised trials. Physiotherapy was the most commonly investigated profession. A meta-analysis of randomised, controlled trials showed that providing additional weekend allied health services in subacute rehabilitation wards reduced hospital length of stay by 2.35days (95% CI 0.45 to 4.24, I 2 =0%), and may be a cost-effective way to improve function (SMD 0.09, 95% CI –0.01 to 0.19, I 2 =0%), and health-related quality of life (SMD 0.10, 95% CI –0.01 to 0.20, I 2 =0%). For acute general medical and surgical hospital wards, it was unclear whether the weekend allied health service model provided in the two identified randomised trials led to significant changes in measured outcomes. Conclusion The benefit of providing additional allied health services is clearer in subacute rehabilitation settings than for acute general medical and surgical wards in hospitals. Registration PROSPERO CRD76771. [Sarkies MN, White J, Henderson K, Haas R, Bowles J, Evidence Translation in Allied Health (EviTAH) Group (2018) Additional weekend allied health services reduce length of stay in subacute rehabilitation wards but their effectiveness and cost-effectiveness are unclear in acute general medical and surgical hospital wards: a systematic review. Journal of Physiotherapy 64: 142–158].
机译：问题附加的周末专职医疗服务对急性普通内科和外科病房以及亚急性康复医院病房是否有效且具有成本效益？设计对2000年1月至2017年5月之间发表的研究进行系统评价和荟萃分析。两名评价者独立筛选研究的纳入，提取数据并评估方法学质量。进行荟萃分析以评估疗效的相关指标。参与者进入急性普通内科和外科病房以及亚急性康复病房的患者。干预在周末（星期六和/或星期日）由专职医疗专业人员提供的所有服务。这项研究将专职医疗保健限于以下领域：职业治疗，物理疗法，社会工作，言语病理学，饮食学，艺术疗法，按摩疗法，运动生理学，音乐疗法，口腔保健（非牙科），整骨疗法，足病学，心理学和专职医疗助手。结果指标住院时间，住院再住院，不良事件，出院目的地，功能独立性，与健康有关的生活质量以及医院护理费用。结果共鉴定出19篇文章（20篇研究），包括10项随机试验和10项非随机试验。物理疗法是最常被调查的职业。对随机对照试验的荟萃分析表明，在亚急性康复病房中提供额外的周末专职医疗服务可将医院住院时间减少2.35天（95％CI 0.45至4.24，I 2 = 0％），并且可能是一项成本改善功能的有效方法（SMD 0.09，95％CI –0.01至0.19，I 2 = 0％）和健康相关的生活质量（SMD 0.10，95％CI –0.01至0.20，I 2 = 0％）。对于急性普通内科和外科医院病房，尚不清楚在两个确定的随机试验中提供的周末联合健康服务模式是否导致测量结果的显着变化。结论在亚急性康复环境中，与在医院的急性普通内科和外科病房相比，提供额外的专职医疗服务的好处更加明显。注册PROSPERO CRD76771。 [Sarkies MN，White J，Henderson K，Haas R，Bowles J，专职医疗证据翻译（EviTAH）组（2018）额外的周末专职医疗服务减少了亚急性康复病房的住院时间，但其有效性和成本效益尚不清楚在急性普通内科和外科医院病房：系统评价。物理治疗杂志64：142–158]。

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