IMPORTANCE: Interventions that prevent falls, facilitate discharge after hospitalization, and reduce hospital readmissions assist occupational therapy practitioners in demonstrating professional value, improving quality, and reducing costs. OBJECTIVE: In this systematic review, we address three outcome areas of the Improving Medicare Post-Acute Care Transformation (IMPACT) act of 2014: prevention and reduction of falls, facilitation of community discharge and reintegration, and prevention of hospital readmission. DATA SOURCES: We conducted a search of the literature published between 2009 and 2019. STUDY SELECTION AND DATA COLLECTION: We developed operational definitions to help us identify articles that answered the search question for each outcome area. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. FINDINGS: We found 53 articles that address the three outcome areas. Regarding the prevention and reduction of falls, low strength of evidence is available for interventions focusing on a single fall risk and for customized interventions addressing multiple risks. Moderate strength of evidence supports structured community fall risk prevention interventions. Low strength of evidence was found for community discharge and reintegration interventions that include physical activity and educational programming. Low to moderate strength of evidence was found for readmission prevention interventions for patients with four types of condition. CONCLUSION AND RELEVANCE: Several intervention themes in the three outcome areas of interest are supported by few studies or by studies with a moderate risk of bias. Additional research is needed that supports the value of occupational therapy interventions in these outcome areas.
Copyright by the Amerrican Occupational Therapy Association Inc. Reprinted with permission.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• PDF locator
• publisher