Developing guidance on necessary & avoidable care transitions in senior citizens

Abstract

The doctoral dissertation is based on two articles. The first reports on a Delphi study aimed to deliver a new consensus-based definition of “avoidable care transitions”. The second publication reports on a systematic literature review aimed to identify and comprehensively describe the assessment tools addressing avoidable care transitions that can support interest-holders´ decisions on older adults. As a result, the new definition encompasses three dimensions: balance of benefit and harm, resource consumption, notion of patient´s preferences. The systematic literature search identified 58 relevant studies on 48 assessment tools. All of the reviewed tools are not comprehensive with respect to the dimensions covered. The new definition can enhance the understanding of avoidable care transitions. Review findings are systematically summarised in a clinically accessible website, and can support informed decision-making when choosing the right tool addressing avoidable care transitions.