Components of the transitional care model (TCM) to reduce readmission in geriatric patients: a systematic review

BMC Geriatrics

Table 3 Qualitative assessment of intervention intensity

Study ID/ Length of intervention	Number of components in the pre-discharge phase^a	Number of components in the post-discharge phase^a	First visit at home or telephonic contact after hospital discharge^b	Combination of home visit and other type of follow-up^c	Number of scheduled home visits and/or telephone follow-up^d	Duration of the intervention^e	Availability of the health professional^f	Total score of intervention intensity	Intervention Intensity level
Clemson 2016 [28] At one month of intervention	6	3	1	3	2	1	1	16	Moderate intensity
López Cabezas 2006 [29] At two months of intervention	6	4	1	1	2	2	2	18	Moderate intensity
At six months of intervention	6	4	1	1	4	2	2	20	Moderate intensity
At 12 months of intervention	6	4	1	1	2	3	2	19	Moderate intensity
Rich 1995 [30] At two months of intervention	9	6	2	3	4	2	2	28	High intensity

Notes: ^aOne point was assigned for each TCM component used (Screening = 1, Staffing = 1, Maintaining Relationships = 1, Engaging Patients & Caregiver = 1, Assessing/Managing Risks & Symptoms = 1, Educating/Promoting Self-Management = 1, Collaborating = 1, Promoting Continuity = 1, Fostering Coordination = 1)
^bFirst visit at home or telephonic contact after hospital discharge (First home visit or telephonic contact after 3 days of hospital discharge = 1, First home visits or telephone contact between 24 h to 3 days of hospital discharge = 2, First home visit or telephone contact within 24 h of hospital discharge = 3)
^cCombination of home visit and other type of follow-up (Telephone follow-up or other type of follow-up without home visits = 1, Only home visits = 2, Home visits combined with telephone follow-up or other type of follow-up = 3)
^dNumber of scheduled home visits and/or telephone follow-up (1 = 1, 2–3 = 2, 4–5 = 3 and 6 or more = 4)
^eDuration of intervention (30 days = 1, 31–180 days = 2, and 181–365 days = 3)
^fAvailability of the health professional (< 7 days or unable to determine = 1, 7 days = 2)
Finally, in order to compare the intensity scores of the interventions, three categories were created (Low intensity = 1–10 points, Moderate intensity = 11–21 points, High intensity = 22–31 points)

ISSN: 1471-2318